RESUMO
To use intensive regimen of pulse steroid in the severe forms of Alopecia areata. This prospective randomized study was conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between 2003 to 2009. Patients with Alopecia universalis, Alopecia totalis, or Alopecia ophiasis were assigned to one of the 3 treatment groups: Group A received oral mega pulse methylprednisolone [MP] for 3 consecutive days once every 2 weeks for 24 weeks; Group B received 2 consecutive daily pulses every 3 weeks; and Group C received 3 consecutive daily pulses every 3 weeks. Patients who showed regrowth of 75% or more at 24 or 36 weeks continued their treatment, while intervals were increased gradually. Forty-two patients were included in this study, and 52.4% of them had atopic diathesis, while 35.7% had autoimmune thyroiditis. At 36 weeks, 12 [28.6%] patients had adequate response, 9 [21.4%] had inadequate response, and 21 [50%] patients had poor response. The response rate shows no statistically significant difference between treatment groups. There were statistically significant differences in age of onset, duration of the disease, and presence of subclinical hypothyroidism between different response groups. At follow-up: 13 [38.2%] patients relapsed; 5 [14.7%] patients developed moderate hair fall; 3 [8.8%] patients developed mild hair fall; 7 [20.1%] patients maintained their hair regrowth; and 6 [17.6%] patients were lost follow up. It was relatively well-tolerated among groups B and C. Oral mega pulse MP use in severe forms of Alopecia areata has relative efficacy and tolerance but with high relapse rate
RESUMO
The aim of this study is to present some of the clinical and allergic features of nickel sensitivity in patients from the Riyadh area and to compare the data with similar studies from other regions. Out of 320 patients, 100 patients gave a positive patch test to nickel sulfate alone or in association with other allergens. These were included in this analysis. The patients were patch-tested with the European standard series which included nickel sulfate 5% in petrolatum. Of the 320 patients, 100 [31.3%] showed a positive reaction to nickel sulfate either alone [43=13.4%] or in association with other allergens [57=17.8%]. In the first group who reacted to nickel sulfate alone, there were 6 men and 27 women [ratio 1:6.2]. In the second group there were 17 men and 40 women [ratio 1:2.4]. Nickel appeared to be the most common cause of contact dermatitis in this region. This is in agreement with reports from other parts of the world. Women are more commonly affected with a tendency to show single sensitivities. We suggest that all patients with hand and foot dermatitis should be tested for nickel sensitivity. Since prevention is difficult, early diagnosis seems to be the only practical measure at the present time