Hair Regrowth Outcomes of Contact Immunotherapy for Patients With Alopecia Areata

Lee, Solam; Kim, Beom Jun; Lee, Young Bin; Lee, Won‐Soo

doi:10.1001/jamadermatol.2018.2312

Cited by 69 publications

(72 citation statements)

References 34 publications

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“…Contact immunotherapy is highly recommended as a treatment of AA. Although the mechanism underlying its effectiveness is still not fully understood, its modification of immune balance may contribute to the therapeutic improvement [ 43 ]. Repeated elicitation of contact hypersensitivity by a hapten induces a shift in the cutaneous cytokine milieu from a Th1 to a Th2 profile [ 44 ], thereby downregulating the type1 reaction and exerting a possible therapeutic efficacy in AA lesions.…”

Section: Discussionmentioning

confidence: 99%

Immunological Properties of Atopic Dermatitis-Associated Alopecia Areata

Kageyama

Ito

Hanai

et al. 2021

IJMS

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Alopecia areata (AA) is regarded as a tissue-specific and cell-mediated autoimmune disorder. Regarding the cytokine balance, AA has been considered a type 1 inflammatory disease. On the other hand, AA often complicates atopic dermatitis (AD) and AD is regarded as type 2 inflammatory disease. However, the immunological aspects of AA in relation to AD are still poorly understood. Therefore, we aim to clarify the immunological properties of AD-associated AA. In this study, we performed comparative analysis of the expression of intracytoplasmic cytokines (IFN-γ, IL-4, and IL-13), chemokine receptors (CXCR3 and CCR4) in peripheral blood which were taken from healthy controls, non-atopic AA patients, AA patients with extrinsic AD, and AA patients with intrinsic AD by flowcytometric analysis. We also compared the scalp skin samples taken from AA patients with extrinsic AD before and after treatment with dupilumab. In non-atopic AA patients, the ratios of CD4+IFN-γ+ cells to CD4+IL-4+ cells and CD4+IFN-γ+ cells to CD4+IL-13+ cells were higher than those in AA patients with extrinsic AD. Meanwhile, the ratio of CD8+IFN-γ+ cells to CD8+IL-13+ cells was significantly higher in the non-atopic AA than in the healthy controls. In AA patients with extrinsic AD, the skin AA lesion showed dense infiltration of not only CXCR3+ cells but also CCR4+ cells around hair bulb before dupilumab treatment. However, after the treatment, the number of CXCR3+ cells had no remarkable change while the number of CCR4+ cells significantly decreased. These results indicate that the immunological condition of AA may be different between atopic and non-atopic patients and between extrinsic and intrinsic AD patients. Our study provides an important notion that type 2 immunity may participate in the development of AA in extrinsic AD patients. It may be considered that the immunological state of non-atopic AA is different from that of atopic AA.

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Section: Discussionmentioning

confidence: 99%

Immunological Properties of Atopic Dermatitis-Associated Alopecia Areata

Kageyama

Ito

Hanai

et al. 2021

IJMS

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“…Recent systematic reviews have revealed that DPCP is effective in alopecia areata, with an average response rate of 53.75% 7 to 65.5%. 8 Luk et al previously demonstrated that DPCP is an effective and tolerable treatment in Chinese patients with extensive, steroid resistant AA. 9 Notably, however, previous studies have used heterogenous measurements for clinical response, with some studies using interquartile ranges and some studies using arbitrary cutoffs for previous Singaporean study showed 87.5% of patients showed more than 50% mean regrowth at the end of 6 months, which is higher than the 51.6% seen in our study, although this could be due to SADBE being used as the contact sensitizer rather than DPCP.…”

Section: Discussionmentioning

confidence: 99%

“…Recent systematic reviews have revealed that DPCP is effective in alopecia areata, with an average response rate of 53.75% 7 to 65.5% 8 . Luk et al previously demonstrated that DPCP is an effective and tolerable treatment in Chinese patients with extensive, steroid resistant AA 9 .…”

Section: Discussionmentioning

confidence: 99%

Limited efficacy of diphenylcyclopropenone in the treatment of alopecia areata: Experience from a Tertiary Healthcare Institution in Singapore

Leong

Mok

Chandran

2020

Dermatologic Therapy

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Alopecia areata (AA) is a common cause of nonscarring hair loss. Diphenylcyclopropenone (DPCP) is a form of contact immunotherapy used in the treatment of AA. We retrospectively reviewed all patients who were diagnosed with AA over a 4-year period (1st January 2012 to 31st December 2015) and who have received DPCP. Forty patients were studied in total. The mean duration of disease prior to the study was 195 days. Patients received a mean number of 14.91 sessions (range: 1-65). The mean number of sessions required before clinical response was seen was 2.33 sessions, corresponding to 0.001% DPCP. Based on the modified Global Assessment Grading System, 33.5% (n = 11) of the patients experienced less than 25% improvement, 48.5% (n = 16) experienced 25%-74% improvement and 18.3% (n = 6) experienced more than 75% improvement. One patient had severe sensitisation reaction amounting to near erythroderma which resolved completely upon cessation of DPCP therapy. No other adverse reactions were noted in the cohort. DPCP remains a valuable tool in a dermatologist's armamentarium in treating alopecia areata as it is safe, well-tolerated, and shows limited efficacy.

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“…recurrences after treatment discontinuation were common (recurrence rates were 38.3% among patients receiving maintenance treatment and 49.0% among those not receiving maintenance treatment). 53 Topical immunotherapy can be performed with DPCP or SADBE, while DNCB was found mutagenic. DPCP is usually preferred over SadBe because it is less expensive and more stable in solution.…”

Section: Topical Immunotherapymentioning

confidence: 99%

Italian Guidelines in diagnosis and treatment of alopecia areata

Rossi¹,

Mellai²,

Piraccini³

et al. 2019

G Ital Dermatol Venereol

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Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The italian Study Group for Cutaneous annexial disease of the italian Society of dermatology proposes these italian guidelines for diagnosis and

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Hair Regrowth Outcomes of Contact Immunotherapy for Patients With Alopecia Areata

Cited by 69 publications

References 34 publications

Immunological Properties of Atopic Dermatitis-Associated Alopecia Areata

Immunological Properties of Atopic Dermatitis-Associated Alopecia Areata

Limited efficacy of diphenylcyclopropenone in the treatment of alopecia areata: Experience from a Tertiary Healthcare Institution in Singapore

Italian Guidelines in diagnosis and treatment of alopecia areata

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