Topical diphenylcyclopropenone plus topical 0.5% anthralin versus topical diphenylcyclopropenone alone for the treatment of chronic extensive alopecia areata: A split-scalp, double-blind, controlled study.

Background: The combination of diphenylcyclopropenone (DCP) and anthralin may demonstrate synergistic effects in the treatment of chronic extensive alopecia areata (AA). Objective: The objective of the study was to compare the efficacy of the combination therapy of topical DCP and topical 0.5% anthralin versus topical DCP alone for the treatment of chronic extensive AA. Materials and Methods: Ten patients were included in the study. Of these, 1, 2, and 7 patients were diagnosed with alopecia totalis, severe AA (>50% hair loss), and alopecia universalis, respectively. For each patient, one side of the scalp was treated with a DCP solution and 0.5% anthralin for 6 months, while the other side was treated with DCP and a cream base for the same duration. The clinical responses were assessed at baseline and then monthly until the end of the 6-month study period using the Severity of Alopecia Tool score. The side effects were evaluated at each follow-up visit. Results: The difference in the efficacies of the combination treatment and DCP alone was not statistically significant (P = 0.59). Regarding the side effects, DCP plus 0.5% anthralin caused significantly more excessive dermatitis than DCP alone (7 patients vs. 2 patients; P = 0.02). Eight patients reported temporary hyperpigmentation at the combination-treatment site, whereas no hyperpigmentation was reported at the DCP-alone site of any patient (P < 0.001). Conclusions: The combination of DCP and 0.5% anthralin was not superior to DCP alone for the treatment of chronic extensive AA. An increase in side effects - excessive dermatitis and hyperpigmentation - was observed in the combination-treatment group.

Accuracy of a high-intensity focused ultrasound device with and without real-time visualization system in face and neck treatment of skin laxity.

BACKGROUND: Microfocused ultrasound (MFU) is a nonsurgical treatment for the improvement of skin laxity. Multiple MFU devices with and without a visualization system are commercially available. AIMS: This study aims to compare the accuracy rates of MFU on target treatment areas with and without a visualization system. PATIENTS/METHODS: A cross-sectional study was conducted using 52 dermatologists as study subjects. Each subject was asked to treat one simulated volunteer on the face and upper neck with MFU for 2 sessions using the training mode. Participants were allowed to see the ultrasound monitoring screen in one session (visualized session) and were not allowed to see the monitoring screen in the other session (nonvisualized session). One investigator evaluated the accuracy rate by monitoring real-time whether an appropriate contact between the transducer and the skin is shown on the visualization system when the energy release button is pressed. RESULTS: Higher accuracy rates were observed in the visualized session than the nonvisualized session in all treatment areas including brow, lateral orbit, infraorbital, cheek, and upper neck. The greatest difference in accuracy rates was observed when performing the treatment on the upper neck. Participants with more experiences had higher accuracy rates while performing visualization session when compared to those who had less experiences. Visualized sessions required a significantly longer treatment time. CONCLUSIONS: The utilization of MFU with visualization system increases the likelihood of proper skin contact. This in turn may give a more favorable treatment outcome and decrease the rates of complications from MFU treatment.