Systemic corticosteroids in alopecia totalis.

Two cases of alopecia totalis are presented and some observations made on the course and treatment of the disorder. The stimulus for extensive alopecia areata appears to occur for short periods in at least some cases and may, therefore, be amenable to shorter courses of systemic corticosteroids than was formerly thought possible. Discontinuing systemic therapy does not always result in a rapid recurrence of totalis and bouts of alopecia partialis which may follow its discontinuance may be managed by more conservative means. In addition, areas resistant to 30 mg. of prednisone per day may respond to topical and intralesional therapy even while prednisone is being reduced considerably below this level.