International Journal of Trichology International Journal of Trichology
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Year : 2018  |  Volume : 10  |  Issue : 3  |  Page : 99-102

Mesalazine in the treatment of extensive alopecia areata: A new therapeutic option?

1 Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre; Pediatric Dermatology Unit, Hospital da Criança Santo Antônio Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, RS, Brazil
2 Dermatology Service, ISCMPA, Porto Alegre, Brazil
3 Section of Dermatology, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande Do Sul, Porto Alegre, RS, Brazil

Correspondence Address:
Prof. Ana Elisa Kiszewski
Rua Sarmento Leite, 245, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijt.ijt_14_18

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Background: Alopecia areata (AA) is a T-lymphocyte-mediated disease that results in alopecia plaques or diffuses alopecia on the scalp and body. Etiologic factors include genetic and autoimmune susceptibility. Treatment modalities are usually considered according to the extent of hair loss and the patient's age. Since there is no approved treatment by the US Food and Drug Administration, treatment options and combinations available are off-label. Patients with extensive AA (including totalis and universalis) have a low rate of spontaneous remission and poor treatment response. Extensive AA is usually associated with severe emotional distress, social discomfort, bullying, and other psychological problems for the child and family. In this context, the need for new therapeutic schemes is clear. Materials and Methods: We retrospectively analyzed five patients (aged 2–17 years) with extensive and refractory AA who were treated with mesalazine associated or not with oral prednisolone and topical betamethasone/minoxidil. Results: We observed complete growth of terminal hair in all patients. No patient had abnormal laboratory results or manifested drug side effects. Conclusions: In extensive and refractory AA cases, the topical treatment combined with mesalazine may provide excellent results, reducing the need for extended oral corticosteroids courses. Besides that, mesalazine seems to minimize relapses on discontinuation of oral steroids. Controlled studies are needed to confirm the effectiveness of this combination.

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