BACKGROUND: Given the limited number of therapeutic options, severe @entity1663 ( @entity1663 ) poses a clinical challenge. The best and most rapid response rates can be achieved with high-dose systemic corticosteroids, however, relapse following treatment discontinuation is inevitable. Due to systemic side effects, long-term high-dose @entity228 regimens are not feasible. Following initial pulse therapy, continuation of @entity228 therapy at a dose below the Cushing threshold might be able to suppress disease activity without causing severe side effects. @entity1 AND METHODS: Thirteen @entity1 with severe @entity1663 were enrolled in our open observational study. Seven had @entity1665 or universalis; the remaining six @entity1 had multifocal @entity1665 affecting more than 50  % of the scalp. The treatment regimen consisted of initial pulse therapy with @entity617 2  mg/kg PO, which was subsequently tapered to a maintenance dose below the individual Cushing threshold within nine weeks. @entity1 were followed-up for one to three years. RESULTS: Sixty-two percent of individuals showed complete hair regrowth. The mean time to response was 6.6 weeks. Said response was sustained with maintenance therapy for the entire follow-up period. Noticeable side effects included @entity1017 (1-3  kg), which was observed in all @entity1 , and mild @entity479 acne in 23  % of cases. CONCLUSIONS: Sequential high- and low-dose @entity617 therapy is an effective and safe therapeutic option for childhood @entity1663 .

Sequential high- and low-dose systemic @entity228 therapy for severe XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'Children', 'PATIENTS'] @entity1665 :: ('MESH:D000505', 'Disease') :: ['alopecia totalis', 'alopecia'] @entity228 :: ('CHEBI:50858', 'Chemical') :: ['corticosteroid'] @entity1017 :: ('MESH:D015430', 'Disease') :: ['weight gain'] @entity1663 :: ('MESH:D000506', 'Disease') :: ['AA', 'childhood alopecia areata'] @entity617 :: ('MESH:D011239', 'Chemical') :: ['prednisolone'] @entity479 :: ('D013256', 'Chemical') :: ['steroid']
@entity1663 :: (MESH:D000506,Disease) :: ['childhood alopecia areata']
