Subclinical Sensitization with Diphenylcyclopropenone is Sufficient for the Treatment of Alopecia Areata: Retrospective Analysis of 159 Cases

Publication date: Available online 3 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Sung Jay Choe, Solam Lee, Long Quan Pi, Dong In Keum, Chung Hyeok Lee, Beom Jun Kim, Won-Soo Lee
BackgroundContact immunotherapy with diphenylcyclopropenone (DPCP) is presently considered the treatment of choice for extensive alopecia areata (AA). However, a major concern with contact immunotherapy is that it causes various adverse effects (AEs) that contribute to discontinuation of treatment.ObjectiveWe investigated whether a modified DPCP treatment protocol can promote hair regrowth with fewer AEs.MethodsAll patients were sensitized with 0.1% DPCP and began treatment with 0.01% DPCP. Thereafter, the DPCP concentration was slowly increased according to the treatment response and AEs. This was a retrospective review of DPCP treatment with modified protocols in 159 patients with AA.ResultsOf the 159 patients, 46 (28.9%) showed a complete response and 59 showed a partial response (37.1%). No patients had AEs after sensitization. During the treatment, only 3 (1.9%) showed severe AEs, and 55 showed moderate AEs, however all were well controlled with antihistamines alone or antihistamines and medium-potency topical steroids. There was no association between treatment response and AEs.LimitationSample size, subject composition, and the retrospective study design represent potential limitations.ConclusionA modified DPCP treatment protocol with subclinical sensitization could induce a favorable therapeutic response and result in fewer AEs.

Teaser

Conventional diphenylcyclopropenone contact immunotherapy has been used in the treatment of extensive alopecia areata, but can be associated with severe adverse effects (AEs).Even without an eczematous reaction after sensitization, sufficient therapeutic responses were achieved without severe AEs.Sensitization to induce an eczematous reaction may not be required for successful contact immunotherapy.


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