Background: Alopecia areata (AA) is one of the most common autoimmune disorders and its severe types are resistant to almost all conventional therapies. Methotrexate (MTX) has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids.
Aim of the study: was toevaluate the outcome and safety of MTX therapy in patients with severe forms of AA, whether as monotherapy or in combination with systemic or intralesional corticosteroids; and to assess therapeutic response according to sex, age, pattern of AA, disease duration and cumulative MTX dose.
Methods: 28 patients were evaluated in a retrospective, non-controlled study, with alopecia areata in current or prior treatment with methotrexate to assess the therapeutic response according to sex, age, pattern of alopecia areata, disease duration, and cumulative dose of methotrexate as well as the use of systemic corticosteroids or other treatments, and drug safety.
Results: 77.8% % of patients experienced a more than 50% regrowth rate, with the best responses observed in those with Conclusion: methotrexate is a convenient and relatively inexpensive drug that could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary.