Therapeutic Effect of Topical Diphenylcyclopropenone (DPCP) for the Treatment of Extensive Alopecia areata / 대한피부과학회지

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a common dermatologic disorder and the course is so variable that some patients undergo spontaneous remission and others undergo total hair loss. There is no clearly superior therapy for the treatment of alopecia areata. Currently, topical immunotherapy with DPCP represents the most accepted therapeutic modality for the treatment of extensive alopecia areata, but their response rates have varied in the literature. OBJECTIVE: We evaluated the efficacy, prognostic factors, and side effects of DPCP in the treatment of extensive AA. METHOD: Thirty nine patients with extensive AA (>50 % scalp hair loss), treated for at least 6 months at the Department of Dermatology of Inha University Hospital between March 2000 and April 2003 participated in the study. After sensitization with 1% DPCP, progressively higher concentrations beginning from 0.001% were applied weekly onto the entire scalp. The primary study end point, i.e. clinically significant regrowth with DPCP therapy, was defined as a cosmetically acceptable response (as judged by the patient) or significant regrowth resulting in greater than 90% of the scalp being covered with terminal hair (as determined by the investigators) RESULT: A clinically significant regrowth was obtained in 91.3% of the patients with 50% to 99% AA and 50.0% with alopecia totalis/universalis. The overall clinically significant regrowth rate was 74% (29 of 39 patients). Variables associated with clinically significant regrowth were the beginning age of DPCP therapy and the extent of AA. Relapse was observed in 56.3% of the patients who achieved significant hair regrowth after 6 months of follow-up. The Clinically significant adverse effects observed were eczematous reaction with blistering, swelling of cervical lymph nodes, urticaria, and erythema multiforme. CONCLUSION: Treatment with DPCP for extensive AA is very effective. Response of AA patients to DPCP treatment is affected by the beginning age of DPDP therapy and the extent of AA.