{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T22:52:24Z","timestamp":1780699944346,"version":"3.54.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"10","funder":[{"name":"Basic Science Research"},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004085","name":"Ministry of Education, Science and Technology","doi-asserted-by":"publisher","award":["NRF-2019R1A2C1004114"],"award-info":[{"award-number":["NRF-2019R1A2C1004114"]}],"id":[{"id":"10.13039\/501100004085","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004085","name":"Ministry of Education, Science and Technology","doi-asserted-by":"publisher","award":["NRF-2021R1A1A01061447"],"award-info":[{"award-number":["NRF-2021R1A1A01061447"]}],"id":[{"id":"10.13039\/501100004085","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Alopecia areata (AA) has a poor clinical course in children. There are no reliable therapeutic options for children with severe AA, including alopecia totalis (AT) and alopecia universalis (AU).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We evaluated the efficacy and adverse effects of a potent topical corticosteroid (TCS) under occlusion in paediatric patients with severe AA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed records of 23 patients under the age of 10\u2005years with AT or AU treated with a potent TCS (0.05% clobetasol propionate or 0.3% diflucortolone valerate) for 8\u2005h under occlusion with a plastic film. We used the Severity of Alopecia Tool (SALT) to measure clinical improvement. The primary endpoint was a SALT score of \u2264 20 at 6\u2005months. We analysed the change in cortisol levels to identify the long-term safety of TCS therapy on the hypothalamus\u2013pituitary\u2013adrenal axis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nineteen of the 23 patients (83%) reached SALT \u2264 20 at 6\u2005months. Six patients relapsed over the 6-month follow-up period. Four patients were suspected of having adrenal insufficiency. However, the cortisol levels of the patients recovered to normal within 1\u2005month of lowering the TCS potency or changing to nonsteroidal treatments. Limitations include the retrospective design and small sample size.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study shows that a potent TCS occlusion may be a safe treatment option in paediatric patients with severe AA. Further long-term studies are required to evaluate the safety and recurrence of TCS occlusion therapy for paediatric AA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llae085","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T13:37:38Z","timestamp":1710855458000},"page":"1125-1130","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and safety of topical corticosteroid treatment under occlusion for severe alopecia areata in children: a\u00a0single-centre retrospective analysis"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-490X","authenticated-orcid":false,"given":"Young Yoon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Hyuk","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungjin","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyoung","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Min","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Kyun","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Eun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Joon","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Kwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoo-Mi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Chungnam National University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"2024091818144639900_llae085-B1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.5021\/ad.21.202","article-title":"Impact of pediatric alopecia areata on quality of life of patients and their family members: a nationwide multicenter questionnaire study","volume":"34","author":"Choi","year":"2022","journal-title":"Ann 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