Topical Immunomodulation with Diphenlycyclopropenone for Alopecia Areata

Abstract

Introduction: Topical immunotherapy with diphenylcyclopropenone is a treatment option for patients with refractory or extensive alopecia areata. The aim of this study was to evaluate the clinical efficacy and tolerability of diphenylcyclopropenone therapy, in patients with alopecia areata, and identify possible prognostic factors that predict response to treatment. Methods: We conducted a retrospective study that included all patients diagnosed with alopecia areata and treated with diphenylcyclopropenone at our Department. Results: Twenty one patients were included for analysis (15 females and 6 males). Overall, nine patients (42.9%) had some hair regrowth with diphenylcyclopropenone therapy. Of these, five (55.6%) achieved pigmented terminal hair regrowth but with persistent patches of alopecia. Only one patient achieved > 90% of hair regrowth. Older age at onset, broader extent of alopecia at baseline and presence of nail dystrophy were all negative prognostic factors (p < 0.05). Atopy and thyroid dysfunction were not statistically significant as predictors of poor treatment outcome. Adverse effects were documented in 15 patients, most of them were mild and did not lead to treatment interruption. Conclusion: Diphenylcyclopropenone therapy is a viable treatment option in patients with extensive alopecia areata, although the response is partial in the majority of the cases. Limitations of this study include its retrospective nature and the limited number of patients.