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Treating patients for alopecia areata (AA) in its universal form is a difficult task. Topical immunotherapy, methylprednisolone pulse therapy, or psoralen–UV-A, which are proposed for other severe forms of this disease, often have no effect in patients with universal AA. The exact pathogenesis of the disorder is still not known; however, there is growing evidence of a transient, reversible, and tissue-restricted autoimmune process.¹

Extracorporeal photopheresis (ECP) was originally developed for the management of cutaneous T-cell lymphoma.² Other indications from the autoimmune spectrum, such as lupus erythematosus and scleroderma, have recently been treated with encouraging results.³ We have, therefore, carried out ECP in 2 patients with therapy refractory AA universalis.

Report of Cases

The first patient was a 42-year-old white woman with a 12-year history of multifocal AA. She used to observe spontaneous regrowth of the concerned areas within 3 months. Nine months before consultation, widespread universal hair loss occurred. She was treated with . . . [Full Text of this Article]

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