BACKGROUND: Extensive involvernent of alopecia areata seems to be different from the usual common type of alopecia areata in its damage to the patient and its pragnosis. The two forms are best dealt with differently. OBJECTIVE: We performed a clinical observation of a severe form of alopecia areata to understand to its course and therapeuic respones. METHODS: Clinical analysis of 68 cases of severe alopecia areata (37 alopecia totalis, 6 alopecia subtotalis, 13 alopecia universalis, 11 alopecia subtotal universalis, 1 ophiasis) was done for 9 years from 1985 to 1994. RESULTS: 1. The sex distribution was equal. The developrnent of hair loss started before the age of 30 in 67.6%(46/68). Twenty two patients(32.4%) developed the alopecia during the early twenties. The overall mean age was 26.4 years. 2. The duration from the initial hair loss to the involvement of the whole scalp was less than 3 months in 80%(40/50~) of patierits showing whole scalp baldness. 3. Exclamation mark hairs were seen in 85% (57/67) of severe alopecia areata. In 5 patients who were examined just at the start of the hair loss, exclamation mark hairs were found several weeks later. 4. When treated by methyl prednisolone pulse therapy, duration of the disease and type of involvement are the most important prognastic factors as follows. a) 71%(32/45) of patients with less than 6 months duration showed satisfyingly good results cosmetically, but this figure dropped to 30.4% (7/23) in patients with longer than 6 months duration. b) 83.7% (36/43) of patients with alopecia totalis or subtotalis showed good results but this figure dropped to 12%(3/25) in patients with alopecia universalis, subtotal universalis or ophiasis. 5. Methyl prednisolone pulse therapy seemed to be recommended in the acute stage of extensive involvement of alopecia areata. CONCLUSION: Severe alopecia areata has predilection for young adults and seems to show extensive involvement frorn its early stage. Exclamation mark hairs need some time to appear even in their early active stage of hair hedding. Pulse methyl prednisolone therapy is thought to be recommended when the disease is in its early active stage.
Alopecia Areata* ; Alopecia* ; Hair ; Humans ; Prednisolone* ; Scalp ; Sex Distribution ; Young Adult

BACKGROUND: Extensive involvernent of alopecia areata seems to be different from the usual common type of alopecia areata in its damage to the patient and its pragnosis. The two forms are best dealt with differently. OBJECTIVE: We performed a clinical observation of a severe form of alopecia areata to understand to its course and therapeuic respones. METHODS: Clinical analysis of 68 cases of severe alopecia areata (37 alopecia totalis, 6 alopecia subtotalis, 13 alopecia universalis, 11 alopecia subtotal universalis, 1 ophiasis) was done for 9 years from 1985 to 1994. RESULTS: 1. The sex distribution was equal. The developrnent of hair loss started before the age of 30 in 67.6%(46/68). Twenty two patients(32.4%) developed the alopecia during the early twenties. The overall mean age was 26.4 years. 2. The duration from the initial hair loss to the involvement of the whole scalp was less than 3 months in 80%(40/50~) of patierits showing whole scalp baldness. 3. Exclamation mark hairs were seen in 85% (57/67) of severe alopecia areata. In 5 patients who were examined just at the start of the hair loss, exclamation mark hairs were found several weeks later. 4. When treated by methyl prednisolone pulse therapy, duration of the disease and type of involvement are the most important prognastic factors as follows. a) 71%(32/45) of patients with less than 6 months duration showed satisfyingly good results cosmetically, but this figure dropped to 30.4% (7/23) in patients with longer than 6 months duration. b) 83.7% (36/43) of patients with alopecia totalis or subtotalis showed good results but this figure dropped to 12%(3/25) in patients with alopecia universalis, subtotal universalis or ophiasis. 5. Methyl prednisolone pulse therapy seemed to be recommended in the acute stage of extensive involvement of alopecia areata. CONCLUSION: Severe alopecia areata has predilection for young adults and seems to show extensive involvement frorn its early stage. Exclamation mark hairs need some time to appear even in their early active stage of hair hedding. Pulse methyl prednisolone therapy is thought to be recommended when the disease is in its early active stage.
Alopecia Areata* ; Alopecia* ; Hair ; Humans ; Prednisolone* ; Scalp ; Sex Distribution ; Young Adult

The linear IgA bullous dermatosis is a rare chronic vesicobullous disease resembling dermatitis herpetiformis or bullous pemphigoid. We report a case of linear IgA bullous dermatosis developed in a 16 year old female, whose cutaneous lesions were unusually acute. The urticarial wheals started on her buttock and spread to her entire body in two hours and generalized blistering de veloped within four days, The response by dapsone was also dramatic. Routine histological and both direct and indirect immunofluorescent microscopic findings were typical of linear IgA bullous dermatosis.
Adolescent ; Adult* ; Blister ; Buttocks ; Dapsone ; Dermatitis Herpetiformis ; Female ; Humans ; Linear IgA Bullous Dermatosis* ; Pemphigoid, Bullous

BACKGROUND: The main therapeutic method currently used for the treatment of vitiligo vulgaris is either photochemotherapy or corticosteroids. But both of the procedures however require lengthy treatment to obtain a satisfactory result. OBJECTIVE: To determine the increased efficacy of the combination therapy of photochemotherapy with corticosteroid and chlorpromazine compared with the usual monotherapy. METHODS: The combination therapy was done in 29 cases and the results were compared with the results of either monotherapy appearing in the literatures. RESULTS: f the 29 patients, 14(48.3%) patients achieved 100% repigmentation, 7(24.1%) patients 75~50%, 5(17.2%) patients 25~50%, and 3(10.4%) patients less than 25%. For the cured patients, 190.3 days and 32.7 times of photochemotherapy were used. CONCLUSION: The combination therapy is more effective, and the duration of treatment can be greatly reduced compared with either monotherapy.
Adrenal Cortex Hormones ; Chlorpromazine ; Humans ; Methods ; Photochemotherapy ; Vitiligo*