The Optimal Application and Therapeutic Effect of Diphenylcyclopropenone in the Treatment of Alopecia Areata

Im, Myung; Park, Young Oak; Kim, Chang Deok; Seo, Young Joon; Lee, Jeung Hoon; Park, Jang Kyu

Abstract

BACKGROUND: Diphencyclopropenone (DPCP) has recently been reported to be a potent contact sensitizer in the treatment of alopecia areata. However, the concentration for sensitization and optimal treatment method has not been standardized. In addition, highly variable results of DPCP use have been reported to date.
OBJECTIVE
The purpose of our study was to find the optimal concentration for sensitization and to evaluate efficacy, prognostic factors and side effects of DPCP in the treatment of AA.
METHODS
A total of 33 healthy people were enrolled in an open-label clinical trial to ascertain the concentration of DPCP needed for sensitization. The patients were sensitized with 0.1%, 0.5%, 1.0%, 1.5% of DPCP on a 2 cm2 area of each extremity (both arms and legs). We also reviewed the medical records of 48 alopecia areata patients who had been treated with DPCP. We evaluated both therapeutic efficacy and prognostic factors influencing the therapeutic effect of DPCP immunotherapy.
RESULTS
Sensitization of 1.0% DPCP in 91% of patients. This concentration showed a higher sensitization rate than 0.5% DPCP, but a lower irritation rate than 1.5% DPCP. 56.3% (27/48) of patients showed terminal hair growth and 33.3% (16/48) completely responded with a cosmetically-acceptable result. The prognostic factor which influenced the result of therapy was the extent of alopecia areata.
CONCLUSION
Topical DPCP treatment for alopecia is quite effective and well-tolerated. This therapy also provides safe therapeutic benefits if it is carried out with the correct sensitization concentration and treatment procedure.