Topical treatment of alopecia areata

Abstract

It has been shown previously that alopecia areata can be treated with dinitrochlorobenzene (DNCB) and other contact allergens. Whether these agents work by inducing immunologic stimulation or simply a nonspecific inflammatory reaction has not been definitively demonstrated. To test the relative importance of these two mechanisms, we have randomly studied 22 patients with alopecia areata to whom either DNCB or croton oil was applied topically. Sixty-three percent of patients without spontaneous regrowth of hair regrew hair after DNCB application. None of those treated with croton oil regrew hair when treated later with DNCB. Therefore, a proved contact allergen was shown to be required for therapeutic success. Patient acceptance of the induced contact dermatitis was excellent. In light of recent data on the mutagenicity of DNCB to bacteria, other contact allergens for topical immunotherapy are being sought.

Treatment of Alopecia areata with Diphencyprone

“…Some authors report a success rate in more than 50% of patients treated with top ical allergens [1][2][3]14], but many others [10-13, 15, 16] observed less optimistic re sults.…”

Topical immunomodulator therapy with squaric acid dibutylester (SADBE) is effective treatment for severe alopecia areata (AA): Results of an open‐label, paired‐comparison, clinical trial

“…However, long-term efficacy of contact sensitizers has not been adequately assessed, primarily due to the low number of randomized clinical trials and to the highly variable length of follow-up with corresponding lack of data on relapse rates [6][7][8].…”

Treatment of Severe Alopecia Areata with Squaric Acid Dibutylester in Pediatric Patients

“…Since the disease in these patients is frequently associated with atopy (2) and has an early onset (3), it usually carries a poor prognosis. Topical sensitizers now offer more hope for recovery even though success rates have varied (4)(5)(6)(7). Squaric acid dibutylester (SADBE) and diphencyprone (DPC) have been preferred to dinitroclorobenzene (DNCB) in recent years because the last was found to be mutagenic (8)(9)(10)(11)(12)(13)(14).…”