The therapeutic use of topical contact sensitizers in benign dermatoses

Abstract

Topical therapy using contact sensitizers has been practised since the 1960s to treat conditions associated with an altered immunological state. Dinitrochlorobenzene, squaric acid dibutyl ester and diphencyprone are most commonly employed in the therapy of alopecia areata and viral warts. Few dermatology departments in the U.K. provide such treatment. This systematic review discusses the various contact sensitizers used for topical immunotherapy, the methodology of treatment, factors influencing efficacy and likely adverse effects.

Generalized molluscum contagiosum in an HIV patient treated with diphencyprone

“…2 Unfortunately, it is carcinogenic, as just as the nitrogen mustard which had been used to treat cutaneous T-cell lymphoma. The other allergens such as poison ivy, nickel and formalin are unsuitable for topical immunotherapy because they can cross-react with other substances and common in environment.…”

“…The other allergens such as poison ivy, nickel and formalin are unsuitable for topical immunotherapy because they can cross-react with other substances and common in environment. 2 Therefore, the good contact sensitizer should be safe, lack of potential to induce cross-sensitization to other substances and not be a carcinogen. Nowadays, dinitrochlorobenzene (DNCB), squaric acid dibutyl ester (SADBE) and DPC are most common contact sensitizers.…”

“…yield DPC. 2 The standard solvent of DPC is acetone which is a strong Ultraviolet (UV) light absorber. UV radiation and heat cause degradation to DPC.…”

“…Some studies reported successful treatment in molluscum contagiosum, vitiligo, primary and secondary malignant melanoma. [2][3][4][5][6][7] The mechanisms of action include alterations in cytokine levels, nonspecific inflammation and reversal of CD4:CD8 ratio. 8 The common side effects are generalized eczema, urticaria, local blistering and swelling and regional lymphadenopathy.…”

“…DPC has been used in various forms for treatments of recalcitrant and facial warts, and alopecia areata. 2 However, this treatment modality has not been generally used in immunocompromised patients. The present report demonstrated the efficacy of DPC on the treatment of generalized molluscum contagiosum in an HIV patient.…”