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Guidelines for the Management of Patients with Alopecia Areata in Korea: Part II Systemic Treatment

김정은|최지웅|조성빈|장용현|김도영|신현태|신정원|Min Sung Kim|Young Lee|박현선|Jiehyun Jeon|Bark Lynn Lew|Gwang Seong Choi
대한피부과학회 (Korean Dermalogical Association)|2023.06|Annals of Dermatology|제35권 제3호|pp. 205-216|DOI https://doi.org/10.5021/ad.22.167

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KoreaGuidelineTreatmentAlopecia areataTherapeuticsSystemic
주제분류피부과학

초록

Background: Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. Objective: To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. Methods: We searched for relevant studies from inception to May 2021 regarding the sys- temic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommenda- tions. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. Results: Current evidence supports the efficacy of systemic corticosteroids, oral cyclospo- rine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. Conclusion: The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.

Abstract

Background: Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. Objective: To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. Methods: We searched for relevant studies from inception to May 2021 regarding the sys- temic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommenda- tions. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. Results: Current evidence supports the efficacy of systemic corticosteroids, oral cyclospo- rine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. Conclusion: The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.

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