Aghaei Shahin
Department of Dermatology, Jahrom Medical School, Jahrom, Iran.
BMC Dermatol. 2005 May 26;5:6. doi: 10.1186/1471-5945-5-6.
Highly variable results of topical diphenylcyclopropenone (DPCP) in the treatment of alopecia areata have been reported so far. The purposes of the present study were to evaluate the efficacy and tolerability of DPCP treatment in severe alopecia areata.
Twenty-eight patients (16 female and 12 male, 10-35 years old, mean age 25 years) with extensive alopecia areata were enrolled in an open-label clinical trial. After sensitization with 2% DPCP, progressively higher concentrations beginning at 0.001% were applied weekly for 6 months to one side of the scalp, after which, if terminal hair growth was noted, the entire scalp was then treated under the same weekly protocol. The maximum concentration of DPCP in acetone was 2%.
Twenty-seven of 28 patients completed therapy. The overall response rate was 81.5% (22/27), complete remission (90%-100% terminal hair re-growth) was obtained 22.2% (6/27) and partial remission (10%-90% terminal hair re-growth) in 59.3% (16/27). In all patients an eczematous reaction consisting of erythema, itching, and scaling at the site of application were observed. During therapy, other side effects including, occipital lymphadenopathy 40.7% (11/27), severe eczema/blister formation 40.7% (11/27), hyperpigmentation 18.5% (5/27) were observed, but no hypopigmentation, vitiligo, contact urticaria, and erythema multiforme-like reaction were seen in the patients. Nineteen of 27 (70.4%) patients had at least one side effect, other than eczematous reaction. Notably, partial recurrence was observed in 50.9% (13/22) of these patients after 6 to 12 months of follow-up. During the follow-up time the maintenance DPCP immunotherapy was continued.
Topical DPCP treatment for alopecia areata is an effective therapy with a slightly high relapse rate during bilateral maintenance treatment. According to the author's knowledge this is the first experience with DPCP in Iran.
迄今为止，已有报道称外用二苯环丙烯酮（DPCP）治疗斑秃的效果差异很大。本研究的目的是评估DPCP治疗重度斑秃的疗效和耐受性。
28例广泛性斑秃患者（16例女性，12例男性，年龄10 - 35岁，平均年龄25岁）纳入一项开放标签的临床试验。用2% DPCP致敏后，从0.001%开始，每周在头皮一侧应用逐渐升高浓度的药物，持续6个月，之后，如果观察到终毛生长，则按照相同的每周方案对整个头皮进行治疗。丙酮中DPCP的最大浓度为2%。
28例患者中有27例完成治疗。总有效率为81.5%（22/27），完全缓解（终毛再生90% - 100%）率为22.2%（6/27），部分缓解（终毛再生10% - 90%）率为59.3%（16/27）。在所有患者中，均观察到用药部位出现由红斑、瘙痒和脱屑组成的湿疹样反应。治疗期间，还观察到其他副作用，包括枕部淋巴结病40.7%（11/27）、严重湿疹/水疱形成40.7%（11/27）、色素沉着18.5%（5/27），但患者中未出现色素减退、白癜风、接触性荨麻疹和多形红斑样反应。27例患者中有19例（70.4%）除湿疹样反应外至少出现一种副作用。值得注意的是，在随访6至12个月后，这些患者中有50.9%（13/22）出现部分复发。在随访期间继续进行维持性DPCP免疫治疗。
外用DPCP治疗斑秃是一种有效的疗法，但在双侧维持治疗期间复发率略高。据作者所知，这是伊朗首次使用DPCP的经验。
