Contact Allergy as a Therapeutic Tool for Alopecia Areata: Application of Squaric Acid Dibutylester

Abstract

Squaric acid dibutylester (SADBE), a potent contact allergen, was tested for mutagenicity in the bacterial plate incorporation assay (Ames test), in the presence and absence of mammalian microsomes. In contrast to dinitrochlorobenzene which is mutagenic in this test, SADBE was found not to be mutagenic. In 53 patients with extensive or total alopecia areata, SADBE dissolved in acetone was applied weekly to one side of the head, the other side serving as control. In 46 patients (87%), hair regrew either exclusively on the treated side, or considerably faster and denser on this side. In some patients, continuous treatment failed to maintain the response. Persistent response was observed in 37 patients (70%). These results are essentially the same as those obtained with DNCB. Therefore, contact allergy is proposed as a therapeutic concept for alopecia areata.

Topical Immunotherapy in Alopecia areata: Anamnestic and Clinical Criteria of Prognostic Significance

“…Our findings, which show that patients with AA totalis and universalis have a less favorable prognosis than pa tients with patchy AA, are in accordance with the results of other authors [11,[13][14][15][16], To Van der Steen et al [7] the extent of AA present before therapy is even the major prog nostic factor, whereas 3 other authors reported contradic tory results [4, 17. 18], A second factor of prognostic relevance is the age at on set of the disease.…”

Thymopentin in the Treatment of Severe Alopecia areata

“…Although our results could appear to be unsatisfactory we want to point out that we considered as a success only patients who had a complete hair regrowth after treatment. Our percentage of complete regrowth is therefore comparable with the results obtained by other authors [6,12,[13][14][15][16][17][18][19] in the treatment of severe AA. The effectiveness of Thymopentin in AA is possibly related to the effects of this drug on the aberrant T-cell-mediated immunity as sociated with this disease.…”

The role of lymphocytes in the development and treatment of alopecia areata

“…Use of skin irritants to treat AA have been recorded in literature since ancient times and AA has been treated with contact sensitizing agents for more than 30 years [163][164][165]. Today, diphenylcyclopropenone (DCP) or squaric acid dibutylester (SADBE) are widely used in countries outside of the USA for the treatment of more extensive AA presentations [7].…”