The Side Effects of DPCP Topical Immunotherapy in Alopecia Areata

Ko, Hyun Chang; Kim, Moon Bum; Kim, Sung Jun; Kim, Byung Soo; Jang, Bong Seok; Oh, Chang Keun; Kwon, Kyung Sool

Abstract

BACKGROUND: Diphenylcycloprophenone (DPCP) topical immunotherapy is usually safe and well-tolerated in the treatment of extensive alopecia areata, but some side effects can be problematic to both the physician and the patient.
OBJECTIVE
The purpose of this study was to investigate the type and frequency of side effects to DPCP and theirrelation with therapeutic response during DPCP immunotherapy.
METHODS
Eighty patients with alopeica areata (>25% of scalp hair), alopecia totalis, and alopecia universalis were treated with DPCP immunotherapy. After sensitization with 2% DPCP, progressively higher concentrations beginning at 0.00001% were applied with an interval of 1 to 2 weeks. During the follow-up period, the onset time and types of side effect and therapeutic response were recorded.
RESULTS
Clinically, side effects were experienced by 58.8% of patients and were as follows; dermatitis at the application site (30.0%), dermatitis on a remote site (23.8%), generalized pruritus (13.8%), lymphadenopathy (11.3%), urticaria (8.8%), hyperpigmentation (6.3%), dermographism (2.5%) and vitiligo-like hypopigmentation (1.3%), in order of frequency. There were no serious adverse effects in any of the patients. The patients with better therapeutic response had more side effects than the ones with poor response. Of the many side effects, only lymphadenopathy had any statistical significance with regards to correlation of therapeutic effects and side effects of DPCP.
CONCLUSION
DPCP topical immunotherapy in extensive alopecia areata appears to be safe without significant side effects. By noting the common side effects during each treatment period and the side effects which may be sign of better therapeutic response, we think that the patients' compliance and the therapeutic response can be increased.