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Alopecia areata, presumed to be immunologically based, has no standard therapy with proven efficacy in appropriately controlled studies. Methotrexate has shown efficacy in case reports and small case series.
These authors performed a retrospective review of 31 patients with alopecia areata who were treated with methotrexate at dosages ranging from 10 mg to 25 mg per week. We are not told how doses higher than 15 mg per week were administered. Disease was characterized as multifocal (48.39%), universalis (35.48%), diffuse (9.67%), or totalis (6.45%). Median patient age was 40 years; disease duration ranged from several months to 32 years (median, 4 years).
Hair regrowth of more than 50% occurred in 21 patients; 9 had >75% regrowth and 6 had co…