The Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
J Eur Acad Dermatol Venereol. 2010 Mar;24(3):264-9. doi: 10.1111/j.1468-3083.2009.03401.x. Epub 2009 Sep 8.
The effectiveness of Diphencyprone (DPC) in alopecia areata (AA) was demonstrated in several studies with highly variable response rates ranging from 5% to 85%.
The response rate and variable factors affecting the prognosis were studied focusing on long-term follow-up with or without maintenance therapy.
A total of 135 cases of AA were treated with DPC. Patients were divided into five groups according to the area of scalp affected: Grade 1 AA: 25-49% scalp affection; Grade 2 AA: 50-74% scalp affection; Grade 3 AA: 75-99% scalp affection; alopecia totalis and alopecia universalis. An initial response was defined as appearance of new terminal hair within treated sites. Excellent response was defined as terminal hair covering >75% of the scalp. Relapse meant >25% hair loss. Maintenance therapy meant ongoing therapy once every 1-4 weeks after excellent response. Follow-up was performed to detect any relapse of AA.
Ninety-seven patients continued therapy for >or=3 months. After an initial 3 month lag, cumulative excellent response was seen in 15 patients (15.4%), 47 patients (48.5%), 51 patients (52.6%) and 55 patients (55.7%) after 6, 12, 18 and 24 months respectively in a mean median time of 12 months. The only patient variable affecting the prognosis was baseline extent of AA. Excellent response was seen in 100%, 77%, 54%, 50% and 41% in Grade 1, Grade 2, Grade 3, AA totalis and AA universalis patients respectively. Side-effects were few and tolerable. Hair fall >25% occurred in 17.9% of patients on maintenance and 57.1% of patients without maintenance therapy (P-value=0.025).
Diphencyprone is an effective and safe treatment of extensive AA. A long period of therapy is needed and will increase the percentage of responders especially in alopecia totalis and universalis. Maintenance therapy is recommended to reduce the risk of relapse.
几项研究表明，二苯环丙烯酮（DPC）在斑秃（AA）中的疗效显著，其应答率变化范围很大，为 5%至 85%。
研究在不进行或进行维持治疗的情况下，影响长期预后的应答率和可变因素。
对 135 例 AA 患者进行 DPC 治疗。根据头皮受累面积将患者分为五组：1 级 AA：头皮受累 25-49%；2 级 AA：头皮受累 50-74%；3 级 AA：头皮受累 75-99%；全秃和普秃。初始应答定义为治疗部位出现新的终毛。极好的应答定义为头皮覆盖率>75%。复发意味着>25%的毛发丢失。维持治疗是指在极好的反应后每 1-4 周进行一次持续治疗。进行随访以检测 AA 是否有任何复发。
97 例患者继续治疗>3 个月。经过 3 个月的初始潜伏期，在 12 个月的平均中位时间内，分别有 15 例（15.4%）、47 例（48.5%）、51 例（52.6%）和 55 例（55.7%）患者出现累积性极好的应答。唯一影响预后的患者变量是基线 AA 的严重程度。1 级、2 级、3 级、全秃和普秃患者的极好应答率分别为 100%、77%、54%、50%和 41%。不良反应少且可耐受。维持治疗组有 17.9%的患者脱发>25%，无维持治疗组有 57.1%的患者脱发>25%（P 值=0.025）。
二苯环丙烯酮是一种有效且安全的广泛 AA 治疗方法。需要进行长期治疗，这将增加应答者的比例，特别是在全秃和普秃患者中。建议进行维持治疗以降低复发风险。
