Paulo Müller Ramos1, Alessandra Anzai2, Bruna Duque-Estrada3, Daniel Fernandes Melo4, Flavia Sternberg5, Leopoldo Duailibe Nogueira Santos6, Lorena Dourado Alves7, Fabiane Mulinari-Brenner8. 1. Department of Dermatology and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil. Electronic address: dermato.paulo@gmail.com. 2. Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil. 3. Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. 4. Department of Dermatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. 5. Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 6. Department of Medicine, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Department of Dermatology and Allergology, Hospital do Servidor Público Municipal, São Paulo, SP, Brazil. 7. Department of Tropical Medicine and Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil. 8. Department of Clinical Medicine, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Abstract
BACKGROUND: Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. OBJECTIVE: To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. METHODS: Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. RESULTS/ CONCLUSIONS: Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.
BACKGROUND: Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. OBJECTIVE: To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. METHODS: Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. RESULTS/ CONCLUSIONS: Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.
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