Treatment of alopecia areata with diphencyprone

Chun, Duk Kuy; Eun, Hee Chul; Lee, Yoo Shin

Abstract

Alopecia areata is a relatively common disorded but the exact psthogenesis is still unknown and there is no satisfactory treatment. Recently contact immunotherapy has been studied with dinitrochlorogenzene(DNCB) which is known to have in vitro mutagenecity limiting its clinieal application. In contrast, diphencyprone (DPCP) is a potent contact sensitizing agent which is not known to be mutagenic. We treated 40 patients with alopecia areata who were refraetory to standard treatment.DPCP was dissolved in acetone in concentrations of 0.0001 2%. After sensitization, DPCP was topically applied to the right side of the scalp with left side sewing as control. After obvious hair growt,h, DPCP was applied on both sides of the scalp. A positive respanse was defined as growth of terminal hairs on the scalp. The response rate was estimated by determing the percentage of hair covered areas com- pared to the total area of the scalp. The results were as follows. 1) Of 20 patients who were followed over 3months, 9 patients(45% ) showed positive response, and 6 patients(30%) showed almost complete regrowth of terminal hairs (above 90% of scalp area). 2) The response time varied from 4 weeks to 33 weeks, with average duration of 10.6 weeks. 3) Nine out of forty patients developed side effects such as severe contact eczema, cervical lymph node swelling and vitiligo. Three out of 40 patients had to discontinue therapy due to side effects. 4) Patients with mild alopecia areata ganerslly showed a higher response rate(50%) than those with alopecis totalis(33%) and alopecia universalis(43%), but the differences were not statistically signifieant(p>0.05). 5) No correlation was found between reaponse rates and clinical factors such as age, sex and duration ot the disease. In conclusion, treatment with DPCP was thought to be effective in patients with alopecis areata who were refractory to standard treatment. Further long-term studies may be neees- sary to find out clinical course of the disease after trestment, and long-term safety of this treatment.