Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata

Luk, N. M.; Chiu, L.S.; Lee, Kenneth Kwing Chin; Chau, Carrie T. S.; Lee, Vivian Ming Yan; Chang, Ming; Lam, Y K; Lee, Hau Chi S

doi:10.1111/jdv.12009

Cited by 21 publications

(22 citation statements)

References 25 publications

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“…Systemic corticosteroid is the most useful immunosuppressive therapy for patients with active lesions, but there is little information available on the role of this therapy in chronic refractory AA . Topical immunomodulators, such as squaric acid dibutylester or diphenylcyclopropenone (DPCP), are the best documented treatment options for recalcitrant and extensive AA . Hair regrowth rates with DPCP immunotherapy vary greatly (6–85%), depending on the patient population; however, in our experience, many patients show an unsatisfactory response with continuous hair shedding.…”

Section: Introductionmentioning

confidence: 91%

Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata

Seo

Lee

Hwang

et al. 2016

The Journal of Dermatology

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Severe alopecia areata (AA) can have an unpredictable clinical course and become refractory to contact immunotherapy. Novel treatment options include low-dose interleukin-2 and Janus kinase inhibitors; however, these treatments are still under investigation. Therefore, we evaluated the efficacy and safety of intramuscular (i.m.) triamcinolone acetonide (TAC) as a rescue therapy for refractory AA. We retrospectively analysed efficacy, adverse effects and relapse rate of i.m. TAC monthly in 27 patients with refractory AA. We defined AA as refractory if the patient showed an unsatisfactory response to both systemic treatment (not i.m. TAC) and the consecutive diphenylcyclopropenone immunotherapy. The initial systemic treatment of other forms of corticosteroids and/or cyclosporin was used to control extensive AA involving more than 25% of the scalp. Administration of i.m. TAC for 3-6 months resulted in a 63.0% response rate, and all patients showed inactive disease after treatment. Final hair regrowth negatively correlated with initial scalp involvement (Spearman r = -0.595, P = 0.001). All patients showed complete recovery of adrenocortical reserve within 3 months after the last injection. Adverse effects of systemic steroid therapy were observed only in female patients (dysmenorrhea and osteoporosis). i.m. TAC may provide a valuable therapeutic option to manage active hair loss and facilitate hair regrowth in refractory AA, especially in male patients.

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Section: Introductionmentioning

confidence: 91%

Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata

Seo

Lee

Hwang

et al. 2016

The Journal of Dermatology

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“…In the category of topical immunotherapy, 7 studies were identified (4 retrospective, 3 clinical trials). [13][14][15][16][17][18][19] Five of these studies examined the efficacy of diphenylcyclopropenone (DPCP), one examined the use of DPCP with anthralin, and one examined the efficacy of squaric acid dibutylester (SADBE). 17 The majority of studies defined treatment success as greater than 90% regrowth, though two retrospective studies defined success as >50% regrowth.…”

Section: Topical Immunotherapymentioning

confidence: 99%

“…17 The majority of studies defined treatment success as greater than 90% regrowth, though two retrospective studies defined success as >50% regrowth. 18,19 The success rates for DPCP ranged from 22 to 79%. The mean maximum duration was 154 weeks.…”

Section: Topical Immunotherapymentioning

confidence: 99%

Review of treatment for alopecia totalis and alopecia universalis

et al. 2017

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Alopecia areata (AA) is an autoimmune disease directed at the hair follicle. Although usually limited to patchy hair loss over the scalp (focalis), AA can present as total loss of scalp hair (totalis; AT) or as total loss of both scalp and body hair (universalis; AU). Management of AT and AU can be challenging, and although multiple treatment modalities have been explored, no therapy is currently FDA-approved. This review focuses on the evidence for current treatment options for AT and AU. The PubMed database was searched from January 1, 2000, to September 1, 2016, for clinical trials, retrospective studies, and case reports of treatments for AT and AU. A total of 40 studies were retrieved and analyzed. Therapies studied for AT/AU included: topical immunotherapy, steroids, photodynamic therapy, immunosuppressive agents, TNFα inhibitors, and other therapies, such as sulfasalazine, bexarotene, JAK inhibitors, and simvastatin/ezetimibe. Although certain treatments showed significant hair regrowth, no treatment was completely effective. The most promising therapies with the highest quality data include diphenylcyclopropenone, squaric acid dibutylester, photodynamic therapy, steroids, and cyclosporine in combination with methylprednisolone. High-quality randomized-controlled trials with large sample sizes are lacking. Unified outcome guidelines are encouraged to facilitate the comparison of future studies.

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“…26,27 Systemically, betamethasone and prednisolone are commonly used as mini pulse therapies. 28,29 Other modalities found effective in the treatment of AA include topical minoxidil, 30,31 oral and topical psoralen and ultraviolet A (PUVA), turban PUVA, topical diphenylcyclopropenone as contact-sensitizing immunotherapy, 32 methotrexate, azathioprine, 16 platelet-rich plasma, 33 sulfasalazine, 34 narrow band ultraviolet B, and bexarotene gel. 35 Biologics are ineffective and may cause aggravation during therapy.…”

Section: Mgmjmsmentioning

confidence: 99%

Alopecia Areata: An Update

Jerajani¹,

Rohatgi²,

Agrawal³

2017

MGM Journal of Medical Sciences

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Alopecia areata (AA) is a very common autoimmune disease that leads to unpredictable, relapsing patchy hair loss. Its chronic pathophysiology is still not fully understood. Hair follicles are not destroyed permanently due to which the potential for regrowth of hair is retained for many years, and is possibly lifelong. Clinical presentation varies from small alopecia patches most commonly on the scalp to full body involvement. Characteristic "swarm of bees" appearance on histopathology is confirmatory in acute cases. A variety of therapeutic options are available, but search for new modalities continues as there is a high relapse rate and a number of side effects associated with the available treatment options.

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Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata

Abstract: DPCP is an effective and tolerable treatment for Chinese patients with extensive, steroid resistant AA.

Cited by 21 publications

References 25 publications

Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata

Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata

Review of treatment for alopecia totalis and alopecia universalis

Alopecia Areata: An Update

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