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

Hyunsun Park; Jung Eun Kim; Jee Woong Choi; Do Young Kim; Yong Hyun Jang; Young Lee; Jiehyun Jeon; Hyun-Tae Shin; Min Sung Kim; Jung Won Shin; Sung Bin Cho; Bark-Lynn Lew; Gwang Seong Choi

doi:10.5021/ad.22.167

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

Ann Dermatol. 2023 Jun;35(3):205-216. doi: 10.5021/ad.22.167.

Authors

Hyunsun Park¹, Jung Eun Kim², Jee Woong Choi³, Do Young Kim⁴, Yong Hyun Jang⁵, Young Lee⁶, Jiehyun Jeon⁷, Hyun-Tae Shin⁸, Min Sung Kim⁹, Jung Won Shin¹⁰, Sung Bin Cho¹¹, Bark-Lynn Lew¹², Gwang Seong Choi⁸

Affiliations

¹ Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea.
² Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
³ Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
⁴ Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.
⁵ Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
⁶ Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea.
⁷ Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
⁸ Department of Dermatology, Inha University School of Medicine, Incheon, Korea.
⁹ Department of Dermatology, School of Medicine, Chosun University, Gwangju, Korea.
¹⁰ Department of Dermatology, Seoul National University Bundang Hospital, Bundang, Korea.
¹¹ Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea.
¹² Department of Dermatology, Kyung Hee University School of Medicine, Seoul, Korea. bellotte@hanmail.net.

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 systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. 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 cyclosporine 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.

Keywords: Alopecia areata; Guideline; Korea; Systemic; Therapeutics; Treatment.

Grants and funding

Korean Hair Research Society/Korea