Alopecia areata: topical immunotherapy treatment with diphencyprone

Background Topical immunotherapy with diphencyprone (DPCP) is considered the most effective treatment of alopecia areata (AA). Objective To assess the efficacy of DPCP in the treatment of extensive or long-lasting AA in Greek patients. Methods Sixty-four patients with extensive and/or long-lasting AA were sensitized with 2% diphencyprone. During each weekly subsequent visit, patients were treated with gradually denser concentrations adjusted in order to maintain erythema and itch on the patient's scalp for 48 h. Patients' hair re-growth was evaluated every 3 months for 2 years. Results Forty-five patients responded among the 54 completing therapy (83.3%). Initial response was observed 3.48 +/- 1.05 months after the initial treatment. Twenty patients among the responders achieved a grade 4 response, 15 patients achieved grade 3, 9 patients achieved grade 2, and 1 patient achieved a grade 1 response. The mean duration of treatment until maximum response was 6.14 +/- 1.48 months. Thirty-one patients (68.9%) had a relapse during follow-up and were treated again. The only adverse event among patients completing therapy was contact dermatitis of the face or neck (9 of 54) that resolved after topical corticosteroid application within 7 days. Statistical analysis did not establish any association among duration of AA, age, gender, atopic diathesis, nail involvement and presence of thyroid antibodies with response to treatment. Conclusion Treatment of Greek patients with AA with diphencyprone presents high response rates similar to those reported by previous studies. The treatment is adequately tolerated by most of the patients, and they are willing to repeat it in cases of relapse.