Two Cases of Alopecia Totalis treated with Diphenylcyclopropenone (DPCP) Immunotherapy / 영남의대학술지

Treatments for alopecia areata include topical corticosteroid treatment, corticosteroid intralesional injection, systemic corticosteroid treatment, PUVA(psoralen-UVA) and topical immunotherapy. The therapeutic effects are variable. Alopecia totalis is hard to treat completely. Topical immunotherapy with dinitrochlorobenzene (DNCB), squaric acid dibutyl ester (SADBE) or diphenylcyclopropenone (diphencyprone, DPCP) represents the most accepted therapeutic modality for the treatment of extensive alopecia areata. We report two cases of alopecia totalis treated with DPCP. After DPCP treatment, total scalp hair was completely recovered.

The Clinical Effect of Topical Diphenylcyclopropenone (DPCP) Therapy in the Treatment of Atopic Dermatitis in Children and Adolescents / 대한피부과학회지

BACKGROUND: Atopic dermatitis is the most common chronic skin disease in childhood. Severe atopic dermatitis may require use of topical or systemic corticosteroids. These treatments are prone to several adverse side effects. This paper highlights the impressive effect of diphenylcycloprope none(DPCP) sensitization in some cases of childhood and adolescent atopic dermatitis. OBJECTIVE: The purpose of this study was to examine the effect of DPCP in treating severe atopic dermatitis of children and adolescents. METHODS: Twenty eight patients, who had moderate to severe atopic dermatitis, were recruited in the treatment of DPCP weekly for 10 weeks and followed up for another 4 weeks. Severity of atopic dermatitis was measured using SCORAD index. RESULTS: Sixteen of 28 patients had finished the treatment courses. After 10 weeks of therapy with DPCP, the patient's symptoms were improved and the mean SCORAD index was significantly reduced from 48.9+/-17.8 to 18.0+/-9.1 (p<0.01). During the follow-up period, patients could be managed by topical steroid and oral antihistamine and flare-up was not observed. CONCLUSION: According to our study, DPCP can be an effective, safe and well-tolerated therapy for moderate to severe atopic dermatitis in children and adolescents. We suggest that DPCP may be effective in the treatment of moderate to severe atopic dermatitis of children and adolescents without serious complications.

Erythema Multiforme due to Topical Application of Diphenylcyclopropenone(DPCP) / 대한피부과학회지

We report a case of erythema multiforme following topical application of diphenylcyclopropenone (DPCP), which occurred during the artificial induction of contact dermatitis in one of two volunteer patients of the objective structured clinical examination(OSCE). The characteristic polycyclic erythematous target-like lesions developed on both hands and forearms after fourth sensitization with 0.1% DPCP in a period of a week because of lack of response. In spite of systemic and topical corticosteroid treatment, the skin lesions lasted one month accompanied with dermographic urticaria. A minimal dose of DPCP can be used for initial sensitization to reduce the risk of a severe generalized eruption like erythema multiforme, although allergic reaction is less likely to be dose-dependent.

Erythema Multiforme due to Diphenylcyclopropenone

A 34-year-old man visited our hospital with alopecia areata on the occipital scalp, which began to develop two months prior to his visit. He was sensitized with 0.2% diphenylcyclopropenone(DPCP) in acetone that was applied to the inner side of his right arm. Two weeks after sensitization, we applied DPCP on his bald lesion once weekly for skin challenge. Following the third application of DPCP, polycyclic erythematous target-like lesions developed around the sensitized area. A clinical diagnosis of erythema multiforme was made. Histologically, the target-like lesion showed few eosinophilic dyskeratosis, exocytosis, and hydropic de-generation of basal layer in the epidermis, and mononuclear infiltration around superficial blood vessels in the dermis. We report herein a rare case of erythema multiforme following topical application of DPCP in the treatment of alopecia areata. This complication must be noted because of the wide-spread and frequent use of DPCP in dermatotherapeutic fields.

A Case of Molluscum Contagiosum Treated with Diphenylcyclopropenone Immunotherapy

We are reporting a case of molluscum contagiosum in a 3-year-old boy who showed a good response to diphenylcyclopropenone (DPCP) immunotherapy. The lesions were multiple, 2 to 7mm in size, centrally umbilicated, normal skin-colored papules of 7 months' duration which were distributed on the penoscrotal area, extremities and trunk. In spite of several treatments using extraction and curettage, new lesions developed continuously. The patient was sensitized with 0.1ml of 1% DPCP solution in acetone on his right shoulder and there-after challenged with solution of varying concentrations (0.05 to 0.1%) on his left shoulder once or twice a week to maintain a mild eczema. Clinical improvement was noted 1 week after sensitization and almost all of the lesions cleared after 8 week's treatment.