BACKGROUND:Few data are available concerning the efficiency of pulse corticosteroids in alopecia areata (AA).OBJECTIVE:Our purpose was to assess the long-term outcomes of patients treated with methylprednisolone bolus.METHODS:This study included 60 patients treated between 1995 and 2000. The short-term outcomes were analyzed in 2000. The long-term assessment of 30 patients was performed in 2010 by phone questionnaire.RESULTS:Significant hair regrowth was observed in 10/30 patients at 6 months after the bolus treatment. Half of the plurifocalis AA patients were responders at 6 months, but less than one quarter of alopecia totalis (AT) and alopecia universalis (AU) patients responded. Long-term outcomes were assessed after a mean duration of 12.3 years; 8/10 initial responders had mild or no disease, and 14/20 initial nonresponders had severe AA.CONCLUSIONS:This study confirmed the low efficiency, both short- and long-term, of this treatment for AT and AU.

Expression of Fc epsilonRI and Fc epsilonRII/CD23 was examined by immunocytochemistry and flow cytometry on eosinophils differentiated from human cord blood cells in the presence of human interleukin-3 (rhIL-3), granulocyte/macrophage colony stimulating factor (rhGM-CSF) and interleukin-5 (rhIL-5) and on blood eosinophils purified from normal donors or patients with idiopathic hypereosinophilic syndrome (HES). On cord blood derived eosinophils, Fc epsilonRI expression started at 1 week of culture and increased to reach a plateau at 3 weeks of culture. Fc epsilonRII/CD23 appeared slightly later, after 2 weeks of culture, and the percentage of Fc epsilonRII/CD23-positive eosinophilic cells increased and stayed in plateau. Fc epsilonRI expression on cord blood derived eosinophils was downregulated after culture with interleukin-2 (rhIL-2), interleukin-4 (rhIL-4), rhIL-5, interferon-alpha (rhIFN-alpha), interferon-gamma (rhIFN-gamma). In contrast, the expression of Fc epsilonRII/CD23 on cord blood derived eosinophilic cells was upregulated after culture with rhIL-4, rhIL-5 and rhIFN-gamma, and downregulated with rhIL-2 and rhIFN-alpha. Fc epsilonRI was expressed on about 30% normal donor eosinophils as well as on normodense eosinophils from HES patients but significantly decreased on hypodense eosinophils. In contrast, Fc epsilonRII/CD23, expressed on a very small proportion of normal donor eosinophils, increased from normodense to hypodense eosinophils. These results suggest that Fc epsilonRI on eosinophils might represent one differentiation antigen expressed relatively early, with decreased expression through maturation or activation, whereas Fc epsilonRII/CD23 might rather be considered as a marker of eosinophil activation.