Alopecia Areata Clinical Case Review

Brett King, MD, associate professor of dermatology at the Yale School of Medicine, discusses the results of the case and important points to keep in mind when treating cases of mild alopecia areata:

"What do we see with 2 1/2 milligrams twice a day of oral minoxidil? We see dramatic response. This is treatment with oral minoxidil monotherapy. There's no topical corticosteroid. There's no intralesional corticosteroid involved. It's just oral minoxidil, 2 1/2 milligrams BID. And you see that over five months, he has nearly complete regrowth where he had only progressed prior to this with intralesional corticosteroids, clobetasol and minoxidil 5% foam. And so wrapping up, the Alopecia Areata Scale is a useful tool for evaluating AA severity in clinic. It takes account of multiple aspects of disease that we should all be cognizant of and evaluating in our patients every day whether they have mild, moderate, or severe disease.

Intralesional triamcinolone, 2.5 milligrams per ml to five milligrams per ml. And topical corticosteroids are for sure mainstays of treatment of alopecia areata. But even for mild disease, when these fail and they not infrequently do fail to make our patients better, we have to think of what are we going to do next? And there's more than just me saying that oral minoxidil is useful for this spectrum of disease. We actually have a clinical trial back from 1987 saying that oral minoxidil is useful for all severities of alopecia areata but really in particular for mild to moderate disease. And so again, please consider oral minoxidil in the treatment of all of your patients with alopecia areata but in particular for patients with mild AA or mild persistent AA. Thank you so much for your time and attention and please tune in for subsequent cases that will be presented by Dr. Britt Craiglow and Dr. Maryanne Senna. Thank you so much."