Assessment of treatment efficacy of diphenylcyclopropenone (DPCP) for alopecia areata

Assessment of treatment efficacy of diphenylcyclopropenone (DPCP) for alopecia areata

Background/aim: Alopecia areata (AA) is an inflammatory disease with a genetic and autoimmune basis. Herein, it was aimed to study the efficacy and safety of an immunomodulatory therapeutic agent, diphenylcyclopropenone, while manifesting its association with histopathological features, prognostic factors, and side effects. Materials and methods: In this retrospective study, 98 patients (60 males, 38 females) with alopecia, who were referred to the Hair Disease Polyclinic at the Department of Dermatology, between 2011 and 2015, were included. Together with medical histories and dermatological examinations, a skin biopsy for histopathological examination was conducted for all of the patients prior to therapy. Therapeutic success was evaluated on the basis of the hair regrowth percentage. Results: Regarding the overall treatment success, 33 (34%) patients had complete response, 16 (16%) had partial response (between 50% and 99%), 27 (28%) had minimal response (between 1% and 49%), and 22 (22%) were nonresponders. Both sexs were equally represented in the outcome. Conclusions: There was a significant relation between the severity of alopecia and the treatment outcome (P = 0.038). Patients with AA had significantly better response when compared to those with alopecia totalis and universalis. There was no statistically significant relation with other parameters, such as disease duration, age, sex, atopy history, age of onset, and histopathological features.

___

  • 1. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. Journal of American Academy of Dermatology 2018; 78(1):1-12. doi:10.1016/j. jaad.2017.04.1141
  • 2. Magen E, Chikovani T, Waitman DA, Kahan NR. Association of alopecia areata with atopic dermatitis and chronic spontaneous urticaria. Allergy Asthma Proceedings 2018; 39 (2): 96-102. doi:10.2500/aap.2018.39.4114
  • 3. Happle R, Hausen BM, Wiesner-Menzel L. Diphencyprone in the treatment of alopecia areata. Acta Dermatology and Venereology 1983; 63 (2): 49-52.
  • 4. Ito T, Aoshima M, Ito N, Uchiyama I, Sakamoto K et al. Combination therapy with oral PUVA and corticosteroid for recalcitrant alopecia areata. Archieves of Dermatological Research 2009; 301 (5): 373-80. doi:10.1007/s00403-009-0936-8
  • 5. Rallis E, Nasiopoulou A, Kouskoukis C, Roussaki-Schulze A, Koumantaki E et al. Oral administration of cyclosporin A in patients with severe alopecia areata. International Journal of Tissue Reactions 2005; 27 (3): 107-110. doi:10.1016/S1578- 2190(09)70063-0
  • 6. Smith JR, Akin RS, Wells MJ. Alopecia areata treated with efalizumab: a case with significant hair re-growth after longterm therapy. Journal of Drugs in Dermatology 2009; 8 (8): 758- 760.
  • 7. Strober BE, Siu K, Alexis AF, Kim G, Washenik K et al. Etanercept does not effectively treat moderate to severe alopecia areata: an open-label study. Journal of American Academy of Dermatology 2005; 52 (6): 1082-1084. doi:10.1016/j.jaad.2005.03.039
  • 8. D’Ovidio R. Alopecia areata: news of diagnosis, pathogenesis, and treatment. Italian Journal of Dermatology and Venereology 2014; 149 (1): 25-45. doi:10.4103/ijt.ijt_99_17
  • 9. Holzer AM, Kaplan LL, Lewis WR. Haptens as drugs: contact allergens are powerful topical immunomodulators. Journal of Drugs in Dermatology 2006; 5 (5): 410-416.
  • 10. Wilkerson MG, Connor TH, Henkin J, Wilkin JK, Matney TS. Assessment of diphenylcyclopropenone for photochemically induced mutagenicity in the Ames assay. Journal of American Academy of Dermatology 1987; 17 (4): 606-611. doi:10.1016/ S0190-9622(87)70244-8
  • 11. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part II. Treatment. Journal of American Academy of Dermatology 2010; 62 (2): 203-204. doi:10.1016/j. jaad.2009.10.031
  • 12. Breslow R, Haynie R, Mirra J. The synthesis of diphenylcyclopropenone. Journal of the American Chemical Society 1959; 81 (3): 247-248.
  • 13. Simonetti O, Lucarini G, Bernardini ML, Simoncini C, Biagini G et al. Expression of vascular endothelial growth factor, apoptosis inhibitors (survivin and p16) and CCL27 in alopecia areata before and after diphencyprone treatment: an immunohistochemical study. British Journal of Dermatology 2004; 150 (5): 940-948. doi:10.1111/j.1365-2133.2004.05881.x
  • 14. Gulati N, Suarez-Farninas M, Gilleaudeau P. Topical DPCP induces distinct early and late phase cellular immune reactions in human skin. Journal of Investigative Dermatology 2013; 133 (9): 159-190. doi:10.1038/jid.2014.196
  • 15. Shapiro J. Topical immunotherapy in the treatment of chronic severe alopecia areata. Dermatological Clinics 1993; 11 (3): 611-617. doi:10.1016/S0733-8635(18)30254-7
  • 16. Shapiro J, Tan J, Tron V. Treatment of severe alopecia areata with topical diphenylcyclopropenone and 5% minoxidil: a clinical and immunopathologic evaluation. Journal of Investigative Dermatology 1995; 104 (5): 36. doi:10.1038/jid.1995.54
  • 17. Orecchia G, Perfetti L, Borroni G, Rabbiosi G. Photochemotherapy plus squaric acid dibutylester in alopecia areata treatment. Dermatologica 1990; 181 (2): 167. doi:10.1159/000247914
  • 18. Berth-Jones J, Hutchinson P. Treatment of alopecia totalis with a combination of inosine pranobex and diphencyprone compared to each treatment alone. Clinical and Experimental Dermatology 1991; 16 (3): 172. doi:10.1111/j.1365-2230.1991. tb00339.x
  • 19. Sutherland L, Laschinger M, Syed ZU, Gaspari A. Treatment of alopecia areata with topical sensitizer. Dermatitis 2015; 26 (1): 26-31. doi:10.1097/DER.0000000000000094
  • 20. Van der Steen PH, Van Baar HM, Happle R, Boezeman JB, Perret CM. Prognostic factors in the treatment of alopecia areata with diphenylcyclopropenone. Journal of American Academy of Dermatology 1991; 24 (2 pt 1): 227-230. doi:10.1016/0190-9622(91)70032-w
  • 21. Ohlmeier MC, Traupe H, Luger TA, Böhm M. Topical immunotherapy with diphenylcyclopropenone of patients with alopecia areata-a large retrospective study on 142 patients with a self-controlled design. Journal of European Academy of Dermatology and Venereology 2012; 26 (4):503-7. doi:10.1111/ j.1468-3083.2011.04114.x
  • 22. Durdu M, Özcan D, Baba M, Seçkin D. Efficacy and safety of diphenylcyclopropenone alone or in combination with anthralin in the treatment of chronic extensive alopecia areata: a retrospective case series. Journal of American Academy of Dermatology 2015; 72 (4:640-650. doi:10.1016/j. jaad.2015.01.008
  • 23. Cotellessa C, Peris K, Caracciolo E, Mordenti C, Chimenti S. The use of topical diphencyclopropenone for the treatment of extensive alopecia areata. Journal of American Academy of Dermatology 2001; 44 (1): 73-76. doi:10.1067/mjd.2001.109309
  • 24. Ito T, Ito N, Saatoff M, Hashizume H, Fukamizu H. Maintenance of hair follicle immune privilege is linked to prevention of NK cell attack. Journal of Investigative Dermatology 2008; 128 (5): 1196-1206. doi:10.1038/sj.jid.5701183
  • 25. Ito T, Ito N, Bettermann A, Tokura Y, Takigawa M. Collapse and restoration of MHC class-I-dependent immune privilege: exploiting the human hair folicle as a model. American Journal of Pathology 2004; 164 (2): 623-634. doi:10.1016/S0002- 9440(10)63151-3
  • 26. Ro B. Alopecia areata in Korea. Journal of Dermatology 1995; 22 (11): 858-864. doi:10.1111/j.1346-8138.1995.tb03936.x
  • 27. Weise K, Kretzschmar L, John SM, Hamm H. Topical immunotherapy in alopecia areata: anamnestic for the treatment of extensive alopecia areata. Journal of American Academy of Dermatology 1996; 192 (2): 129-133. doi:10.1159/000246337
  • 28. Iijima S, Otsuka F. Prognostic factors for clinical response of alopecia areata to topical immunotherapy with squaric acid dibutylester. Archieves of Dermatology 1997; 133 (4): 539-540. doi:10.1001/archderm.1997.03890400145035
  • 29. Donovan J, Salsberg J. The safety and efficacy of diphencyprone for the treatment of alopecia areata in children. Archieves of Dermatology 2012; 148: 148 (9):1084-1085. doi: 10.1001/ archdermatol.2012.1622
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Clinical and demographic characteristics of children and adolescents with acute vertigo symptoms: A cross-sectional study

Sema Nilay ABSEYİ, Arzu YILMAZ

The assessment of the serum levels of TWEAK and prostaglandin F2α in COVID – 19

Bahattin AVCI, Mustafa ÇAPRAZ, Caner GÜNAYDIN, Emine SEHMEN, Maruf BORAN, Demet YALÇIN KEHRİBAR, Mustafa CİHANGİROĞLU, Metin ÖZGEN

A single center cohort of 40 severe COVID-19 patients who were treated with convalescent plasma

Oktay OLMUŞÇELİK, Ömür Gökmen SEVİNDİK, Ali MERT, Hülya BİLGEN, Cem ERDOĞAN, Rümeysa DİNLEYİCİ, Aliihsan GEMİCİ, Hüseyin Saffet BEKÖZ, Abdullah KANSU

Comment on: “Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence”

Tevfik Tolga ŞAHİN, Sami AKBULUT

A novel Turkish instrument for assessing quality of life in chronic otitis media – translation and validation of Zurich chronic middle ear inventory

Ziya SALTÜRK, Güler BERKİTEN, David BACHİNGER, Ercan KULAK, Belgin TUTAR, Ayça Başkadem YILMAZER, Muhammed Enis EKİNCİOĞLU, Yavuz UYAR, Semih KARAKETİR, Ece ARKAN, Muhammed Fatih AKGÜN

Influence of aluminum salts on COVID-19 infected patients

Oğuz DOĞAN, Ali DEMİR, Murat KEKİLLİ, İbrahim ERAYMAN

Peripheral axonal excitability in hemiplegia related to subacute stroke

Zeynep TURAN, Murat ZİNNUROĞLU

CD34+ hematopoietic progenitor cell dose as a predictor of engraftment and survival in multiple myeloma patients undergoing autologous stem cell transplantation

Salih AKSU, Yahya BÜYÜKAŞIK, Hakan GÖKER, Haluk DEMİROĞLU, Elifcan ALADAĞ, Nilgün SAYINALP, Osman İlhami ÖZCEBE, İbrahim Celalettin HAZNEDAROĞLU, Mehmet TURGUT

Effects of different epidural initiation volumes on postoperative analgesia in cesarean section

Osman KAÇMAZ, Nurçin GÜLHAŞ, Mahmut DURMUŞ, Gülay ERDOĞAN KAYHAN

COVID-19 experience of the major pandemic response center in the capital: results of the pandemic’s first month in Turkey

Fatma ESER, Müge AYHAN, Elif Mükime SARICAOĞLU, Rahmet GÜNER, Esragül AKINCI, Bedia DİNÇ, Adalet AYPAK, Yeşim AYBAR BİLİR, Nevzat Mehmet MUTLU, Işıl ÖZKOÇAK TURAN, Deniz ERDEM, Turan BUZGAN, Ayşe KAYA KALEM, Bircan KAYAASLAN, İmran HASANOĞLU, Burcu ÖZDEMİR