Search

Objective To summarize the experience of nursing care of patients with severe alopecia areata treated with topical diphenylcyclopropenone. Methods Seventeen patients with severe alopecia areata treated with topical diphenylcyclopropenone were enrolled. Before the treatment, self-protection was given to the therapist and informed consent was given to the patients. During the treatment, the principles of procedure and drug dosages were strictly followed. After the treatment, WeChat APP was used in the follow-up management of patients. This management included one-to-one evaluation of and consultation on efficacy, adverse reactions, diet and psychology. Results Seventeen patients completed the 16-week treatments, with an effective rate of 58.82%. The adverse reactions were mild and controllable. The therapists did not experience any adverse reactions such as allergic reactions. Conclusion In the treatment of severe alopecia areata with topical diphenylcyclopropenone, appropriate pre-operative preparation and post-operative care can effectively improve the patient's compliance and the therapeutic efficacy.

Objective To summarize the experience of nursing care of patients with severe alopecia areata treated with topical diphenylcyclopropenone・ Methods Seventeen patients with severe alopecia areata treated with topical diphenylcyclopropenone were enrolled・ Before the treatment, self-protection was given to the therapist and informed consent was given to the patients・ During the treatment, the principles of procedure and drug dosages were strictly followed・ After the treatment, WeChat APP was used in the follow-up management of patients・ This management included one-to-one evaluation of and consultation on efficacy, adverse reactions, diet and psycholog y・ Results Seventeen patients completed the 16-week treatments, with an effective rate of 58 ・ 82% ・ The adverse reactions were mild and controllable・ The therapists did not experience any adverse reactions such as allergic reactions・ Conclusion In the treatment of severe alopecia areata with topical diphenylcyclopropenone, appropriate pre-operative preparation and post-operative care can effectively improve the patient's compliance and the therapeutic efficacy. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 12-year-old boy with alopecia universalis and trachyonychia, a nail disorder associated with alopecia areata. The patient showed improvement in trachyonychia after treatment with diphenylcyclopropenone (DPCP) for alopecia universalis. The study highlights the relationship between trachyonychia and alopecia areata, as well as the potential systemic therapeutic effects of contact immunotherapy. Dermoscopy was used to monitor the response to treatment, showing promise as a diagnostic and assessment tool for trachyonychia therapies. [Extracted from the article]

PurposeTo investigate the preparation of inclusion complexes of diphenylcyclopropenone (DPCP)/β-cyclodextrin (β-CD) derivatives using a three-dimensional (3D) ball mill, and verify the inclusion behavior of the solid dispersion. Additionally, we aimed to investigate the effect of DPCP/β-CDs complex formation on the spleens of male C57BL/6 mice in terms of anti-inflammatory effects.MethodsThe inclusion complexes of DPCP with β-CD and hydroxypropyl-β-cyclodextrin (HPβCD) were prepared using a 3D ball mill. Powder X-ray diffraction (PXRD) and Fourier-transform infrared spectroscopy (FT-IR) were used to evaluate the solid-state properties. The solubility of the prepared DPCP/β-CD and HPβCD complexes and the intermolecular interaction between DPCP and β-CD derivatives in solution were assessed using 1H nuclear magnetic resonance (NMR). Furthermore, the anti-inflammatory effects of DPCPs in the prepared DPCP/CD complexes were investigated using spleens from male C57BL/6 mice, with measurement of interferon gamma (IFN-γ) secretion as an endpoint. Additionally, the protective effects of each drug on NIH-3T3 cells exposed to ultraviolet (UV) irradiation were examined.ResultsSolid-state characterization confirmed the formation of inclusion complexes in the 3D ground mixture (3DGM) (DPCP/β-CD = 1/1) and 3DGM (DPCP/HPβCD = 1/1) complexes through PXRD and IR analysis. The solubility of 3DGM (DPCP/β-CD = 1/1) and 3DGM (DPCP/HPβCD = 1/1) was 17.5 μg/mL and 58.4 μg/mL, respectively, indicating higher solubility than that of DPCP alone. NMR analysis of 3DGM samples suggested that DPCP/β-CD and DPCP/HPβCD form inclusion complexes at a molar ratio of 1/1 but with different inclusion modes. Regarding the anti-inflammatory activity of DPCP, 3DGM (DPCP/HPβ-CD) showed anti-inflammatory effects at lower doses compared to 3DGM (DPCP/β-CD) in terms of IFN-γ and NIH-3T3 cells injured by UV irradiation.ConclusionWe successfully formed inclusion complexes of DPCP/β-CD and DPCP/HPβCD using the 3D ground mixture method. NMR analysis suggested that DPCP/β-CD and DPCP/HPβCD form inclusion complexes at a molar ratio of 1/1 but with different inclusion modes. The anti-inflammatory activity of DPCP was more pronounced in 3DGM (DPCP/HPβCD) at lower doses compared to that in 3DGM (DPCP/β-CD), indicating that the HPβCD derivatives were more effective in enhancing the anti-inflammatory properties of DPCP.

Background: Alopecia areata (AA) is a common disease characterized by hair loss with an autoimmune background. There are many lines of therapy, but no standard line for all cases. Consequently, treating severe forms of AA is challenging. Objective: This study aimed to compare the efficacy and safety of the combination of diphenylcyclopropenone (DPCP) and platelet‐rich plasma (PRP) with DPCP alone in treating patients with severe or refractory AA. Patients and methods: Our randomized clinical trial was conducted on patients with severe and recalcitrant AA. Group A included 13 patients who received only DPCP, while Group B included 11 patients who received both DPCP and PRP. After sensitization in both groups of patients, DPCP was applied to half the scalp weekly. In addition, PRP injection in all scalp was performed once a month in group B. The patients in both groups completed the study for six months. Results: The regrowth scale results were 53.85% and 54.5% for groups A and B, respectively. Although the response rate of group B was higher than that of group A, there is no statistically significant difference between the two groups. Conclusion: From our clinical trial, it can be concluded that DPCP alone or combined with PRP is an effective and safe method for treating severe or recalcitrant AA. [ABSTRACT FROM AUTHOR]

Objective: To ascertain (1) Diphenylcyclopropenone (DCP)'s efficacy in treating alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) in Thai patients; and (2) prognostic factors. Materials and Methods: We retrospectively reviewed the medical records of patients with AA, AT, and AU who were administered DCP at Siriraj Hospital, Bangkok, Thailand. The median response and relapse times of the 3 groups were evaluated. Factors affecting outcomes were investigated. Results: Fifty-nine cases were enrolled (AA, 22; AT, 9; AU, 28), with women predominating in each group. The overall response was 61% (AA, 78.6%; AT, 66.7%; AU, 50%). The median response time was 58 weeks, with a significantly longer time for AU than AA (P = 0.006). Factors significantly influencing response to DCP, evaluated by multivariate analysis, were older age at onset (P = 0.02), disease duration before DCP initiation (P = 0.003), and treatment duration to initial hair regrowth (P = 0.001). The overall relapse rate was 63.9%, with a median of 39 weeks between response and relapse. The most common side effect was blistering (73.7%). Conclusion: DCP is effective and safe for treating extensive AA. Favorable prognostic factors are low disease severity, late disease onset, short duration before DCP treatment, and short duration to initial response. As the relapse rate is high, maintenance therapy should be considered. [ABSTRACT FROM AUTHOR]

Background: Diphenylcyclopropenone (DPCP) contact immunotherapy has been successfully utilized in various forms for treatments of recalcitrant and facial warts, molluscum contagiosum (MC) and alopecia areata. The objective was to evaluate the safety and efficacy of DPCP in the treatment of MC. Methods: Twenty-four patients with MC were assigned to two groups: twelve patients (group A) were treated with topical application of DPCP one session per week for a maximum of 12 sessions or until clinical cure. Also, twelve patients (group B) were subjected to topical application of normal neutral saline as a control group. Follow-up was done for 3 months. Results: In group A, eight patients (66.7%) showed complete response while four patients (33.3%) showed partial response to the topical application of DPCP after seven to twelve sessions. However, in group B, eleven patients (91.7%) showed no response and (8.3%) showed partial response. A highly significant difference was found in the clinical response between both groups (p<0.05). Adverse effects were minimal and well tolerated in both groups. Conclusion: Diphenylcyclopropenone is safe and effective therapeutic option in treatment of MC and cost effective. [ABSTRACT FROM AUTHOR]

[Display omitted] Cyclopropenone is a valuable electrophilic reagent that can react with electrophilic reagents, nucleophilic reagents, free radicals, organic metals, etc. Furthermore, cyclopropenone derivatives have shown significant biological activity in various diseases, such as triple-negative breast cancer (TNBC), melanoma, and alopecia areata (AA). The cyclopropenone analogue diphenylcyclopropenone (DPCP) has been approved for the treatment of AA. Given the potential therapeutic benefits of cyclopropenone derivatives, this review aims to systematically summarize the structures, synthesis routes, and potential pharmacological functions of cyclopropenone analogues in the hope of offering novel insights for further rational design of more drugs based on the cyclopropenone skeleton for the treatment of human diseases. [ABSTRACT FROM AUTHOR]

Background: Diphenylcyclopropenone (DPCP) is a topical contact allergen used for contact immunotherapy in alopecia areata (AA). Objectives: We aimed to evaluate the treatment effectiveness and prognostic factors in Taiwanese patients with AA treated with topical DPCP. Methods: We performed a retrospective study of all consecutive patients with AA affecting more than 10% of scalp area treated with topical DPCP for more than 90 days. Results: Eighty-six patients were assessed in the study. The greatest hair regrowth percentages of 0%, 1%–25%, 26%–50%, 51%–75%, and 76%–100% were 26.7% (23/86), 7.0% (6/86), 2.3% (2/86), 10.5% (9/86), and 53.5% (46/86) of patients, respectively. 32.6% (28/86) of patients achieved near-complete remission (with or without maintenance DPCP therapy), defined as more than 90% sustainable hair regrowth. Positive prognostic factors include older age of onset, shorter duration of AA before DPCP treatment, less severity of hair loss, and no nonscalp hair loss. Multivariate logistic regression analysis showed that more than a 2-year duration of AA before DPCP treatment (P = 0.015) and more than 90% of hair loss (P = 0.032) had a poorer treatment outcome. Factors including eczematous sensitization reaction, history of atopy, adverse reactions, or concentrations of DPCP do not predict treatment effectiveness. Pigmentary change may cause cosmetic concerns in Chinese ethnicity. Conclusion: Topical DPCP is effective for AA. Various factors were associated with the clinical outcomes. Monitoring the possible adverse events is warranted.

Alopecia areata (AA) is an autoimmune disorder that involves the destruction of anagenic hair follicles, resulting in non-scarring patchy hair loss. The patient presented in the following case had not seen improvement by use of conventional treatments and was started on topical immunotherapy, diphenylcyclopropenone (DPCP). This agent is commonly left as a last resort due to its constant need for follow-up, clinician-required administration, and risk of adverse effects. The following case presents a titration schedule using DPCP, resulting in minimal adverse effects and dramatic improvement in hair regeneration.

Oral mini pulse (OMP) corticosteroids and diphencyclopropenone (DPCP) contact sensitisation are commonly used treatment modalities in severe cases of Alopecia areata (AA) in children but with scarce studies comparing the two modalities in children. In this study we aimed to compare the effectiveness and safety of dexamethasone OMP with DPCP contact sensitization in severe non progressive AA in children. This randomized open label study was undertaken in 30 children less than 18 years of age with extensive non progressive AA divided in two groups. Group I included 15 patients who received dexamethasone (5 mg/week) OMP as five tablets of 0.5 mg dexamethasone (i.e., 2.5 mg dexamethasone) on two consecutive days in a week. Group II included 15 patients who were treated with DPCP contact sensitization. The treatment was continued in all patients for 24 weeks. Patients were followed up every 4 weeks and records were maintained. Response rate was 100% in OMP group and 53.3% in DPCP group at 24 weeks. In Group I, complete regrowth was seen in 20% patients, and cosmetically acceptable regrowth in 66.7% while in Group II, complete regrowth was not seen in any of the patients, and cosmetically acceptable regrowth in 20% (p = 0.001). Hair regrowth started at mean duration of 7.7 weeks in Group I, while 11.3 weeks in Group II. Response rate of treatment with dexamethasone OMP leads to a significantly faster and better hair regrowth compared to DPCP contact immunotherapy in non‐progressive extensive AA in children. [ABSTRACT FROM AUTHOR]

For decades, contact immunotherapy with dinitrochlorobenzene, diphencyprone, and squaric acid dibutylester has played an important role in both clinical practice and scientific research. It is listed as the first-line treatment for extensive alopecia areata and was more recently approved for melanoma treatment as an orphan drug in the USA. Moreover, owing to the relative low cost and safety, topical immunotherapy has also been used in many infectious, neoplastic, and inflammatory dermatological diseases. It is especially valuable in vulnerable groups, for cosmetic/pain sensitive areas, or for multiple lesions. In this review, we summarize the current evidence supporting the use of contact immunotherapy for treatment of skin diseases, from articles collected from PubMed database. Owing to space limitation and already numerous studies focusing on alopecia areata, we include only skin diseases other than alopecia areata. In addition to diseases that have been reported to be treated by contact immunotherapy, the hypothesized mechanism, prognosis prediction, efficacy, and safety of these topical agents are discussed. [ABSTRACT FROM AUTHOR]

Background: Diphenylcyclopropenone (DPCP) is a topical contact allergen used for contact immunotherapy in alopecia areata (AA). Objectives: We aimed to evaluate the treatment effectiveness and prognostic factors in Taiwanese patients with AA treated with topical DPCP. Methods: We performed a retrospective study of all consecutive patients with AA affecting more than 10% of scalp area treated with topical DPCP for more than 90 days. Results: Eighty-six patients were assessed in the study. The greatest hair regrowth percentages of 0%, 1%–25%, 26%–50%, 51%–75%, and 76%–100% were 26.7% (23/86), 7.0% (6/86), 2.3% (2/86), 10.5% (9/86), and 53.5% (46/86) of patients, respectively. 32.6% (28/86) of patients achieved near-complete remission (with or without maintenance DPCP therapy), defined as more than 90% sustainable hair regrowth. Positive prognostic factors include older age of onset, shorter duration of AA before DPCP treatment, less severity of hair loss, and no nonscalp hair loss. Multivariate logistic regression analysis showed that more than a 2-year duration of AA before DPCP treatment (P = 0.015) and more than 90% of hair loss (P = 0.032) had a poorer treatment outcome. Factors including eczematous sensitization reaction, history of atopy, adverse reactions, or concentrations of DPCP do not predict treatment effectiveness. Pigmentary change may cause cosmetic concerns in Chinese ethnicity. Conclusion: Topical DPCP is effective for AA. Various factors were associated with the clinical outcomes. Monitoring the possible adverse events is warranted. [ABSTRACT FROM AUTHOR]

Treatment of alopecia areata is often challenging, especially for patients with extended disease. Contact immunotherapy with diphenylcyclopropenone (DPCP) has been reported as an effective topical treatment but the exact immunologic mechanism of diverting the immune response is still unknown. We investigated the efficacy of topical immunotherapy with DPCD in acute, intermediate, and chronic lesions of AA and the response rate was associated with perifollicular infiltrate of T regulatory cells. Approximately two‐thirds of our patients (67.5%) had a response rate > 50% after 6 months of DPCP therapy. Patients with acute and intermediate onset of the disease were more likely to respond to the therapy. Although responders demonstrated FOXP3+ positive lymphocytes in immunohistochemistry, this association could not be confirmed by statistical significance (p = 0.052). In patients with multiple lesions, that had different chronological onset, the lesions with more recent onset responded faster than lesions of longer duration. [ABSTRACT FROM AUTHOR]

Thipprapai Mahasaksiri, Chaninan Kositkuljorn, Tanaporn Anuntrangsee, Poonkiat Suchonwanit Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Poonkiat SuchonwanitDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, ThailandTel +66 2-2011141Fax +66 2-201-1211 Ext 4Email poonkiat@hotmail.comAbstract: Treatment of extensive or recalcitrant alopecia areata (AA) is a major clinical challenge. Even after thorough investigation of several medications, its treatment outcomes have remained unsatisfactory. While there is no US Food and Drug Administration-approved medication for AA yet, topical immunotherapy has been a well-documented treatment option. Dinitrochlorobenzene, squaric acid dibutylester, and diphenylcyclopropenone are three substances that have demonstrated efficacy in the treatment of extensive or recalcitrant AA. Despite being commonly used, the mechanism underlying topical immunotherapy is not well-elucidated and a wide range of clinical efficacies have been reported in the literature. The aim of this review was to summarize and update the pharmacology, mechanism of action, therapeutic efficacy, and tolerability of topical immunotherapy in the treatment of AA.Keywords: contact sensitizers, dinitrochlorobenzene, diphencyprone, diphenylcyclopropenone, hair loss, squaric acid dibutylester

Background: The combination of diphenylcyclopropenone (DCP) and anthralin may demonstrate synergistic effects in the treatment of chronic extensive alopecia areata (AA). Objective: The objective of the study was to compare the efficacy of the combination therapy of topical DCP and topical 0.5% anthralin versus topical DCP alone for the treatment of chronic extensive AA. Materials and Methods: Ten patients were included in the study. Of these, 1, 2, and 7 patients were diagnosed with alopecia totalis, severe AA (>50% hair loss), and alopecia universalis, respectively. For each patient, one side of the scalp was treated with a DCP solution and 0.5% anthralin for 6 months, while the other side was treated with DCP and a cream base for the same duration. The clinical responses were assessed at baseline and then monthly until the end of the 6 month study period using the Severity of Alopecia Tool score. The side effects were evaluated at each follow-up visit. Results: The difference in the efficacies of the combination treatment and DCP alone was not statistically significant (P = 0.59). Regarding the side effects, DCP plus 0.5% anthralin caused significantly more excessive dermatitis than DCP alone (7 patients vs. 2 patients; P = 0.02). Eight patients reported temporary hyperpigmentation at the combination-treatment site, whereas no hyperpigmentation was reported at the DCP-alone site of any patient (P < 0.001). Conclusions: The combination of DCP and 0.5% anthralin was not superior to DCP alone for the treatment of chronic extensive AA. An increase in side effects -- excessive dermatitis and hyperpigmentation -- was observed in the combination-treatment group. [ABSTRACT FROM AUTHOR]

Oral mini pulse (OMP) corticosteroids and diphencyclopropenone (DPCP) contact sensitisation are commonly used treatment modalities in severe cases of Alopecia areata (AA) in children but with scarce studies comparing the two modalities in children. In this study we aimed to compare the effectiveness and safety of dexamethasone OMP with DPCP contact sensitization in severe non progressive AA in children. This randomized open label study was undertaken in 30 children less than 18 years of age with extensive non progressive AA divided in two groups. Group I included 15 patients who received dexamethasone (5 mg/week) OMP as five tablets of 0.5 mg dexamethasone (i.e., 2.5 mg dexamethasone) on two consecutive days in a week. Group II included 15 patients who were treated with DPCP contact sensitization. The treatment was continued in all patients for 24 weeks. Patients were followed up every 4 weeks and records were maintained. Response rate was 100% in OMP group and 53.3% in DPCP group at 24 weeks. In Group I, complete regrowth was seen in 20% patients, and cosmetically acceptable regrowth in 66.7% while in Group II, complete regrowth was not seen in any of the patients, and cosmetically acceptable regrowth in 20% (p = 0.001). Hair regrowth started at mean duration of 7.7 weeks in Group I, while 11.3 weeks in Group II. Response rate of treatment with dexamethasone OMP leads to a significantly faster and better hair regrowth compared to DPCP contact immunotherapy in non-progressive extensive AA in children. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the preparation of inclusion complexes of diphenylcyclopropenone (DPCP)/β-cyclodextrin (β-CD) derivatives using a three-dimensional (3D) ball mill, and verify the inclusion behavior of the solid dispersion. Additionally, we aimed to investigate the effect of DPCP/β-CDs complex formation on the spleens of male C57BL/6 mice in terms of anti-inflammatory effects., Methods: The inclusion complexes of DPCP with β-CD and hydroxypropyl-β-cyclodextrin (HPβCD) were prepared using a 3D ball mill. Powder X-ray diffraction (PXRD) and Fourier-transform infrared spectroscopy (FT-IR) were used to evaluate the solid-state properties. The solubility of the prepared DPCP/β-CD and HPβCD complexes and the intermolecular interaction between DPCP and β-CD derivatives in solution were assessed using 1H nuclear magnetic resonance (NMR). Furthermore, the anti-inflammatory effects of DPCPs in the prepared DPCP/CD complexes were investigated using spleens from male C57BL/6 mice, with measurement of interferon gamma (IFN-γ) secretion as an endpoint. Additionally, the protective effects of each drug on NIH-3T3 cells exposed to ultraviolet (UV) irradiation were examined., Results: Solid-state characterization confirmed the formation of inclusion complexes in the 3D ground mixture (3DGM) (DPCP/β-CD = 1/1) and 3DGM (DPCP/HPβCD = 1/1) complexes through PXRD and IR analysis. The solubility of 3DGM (DPCP/β-CD = 1/1) and 3DGM (DPCP/HPβCD = 1/1) was 17.5 μg/mL and 58.4 μg/mL, respectively, indicating higher solubility than that of DPCP alone. NMR analysis of 3DGM samples suggested that DPCP/β-CD and DPCP/HPβCD form inclusion complexes at a molar ratio of 1/1 but with different inclusion modes. Regarding the anti-inflammatory activity of DPCP, 3DGM (DPCP/HPβ-CD) showed anti-inflammatory effects at lower doses compared to 3DGM (DPCP/β-CD) in terms of IFN-γ and NIH-3T3 cells injured by UV irradiation., Conclusion: We successfully formed inclusion complexes of DPCP/β-CD and DPCP/HPβCD using the 3D ground mixture method. NMR analysis suggested that DPCP/β-CD and DPCP/HPβCD form inclusion complexes at a molar ratio of 1/1 but with different inclusion modes. The anti-inflammatory activity of DPCP was more pronounced in 3DGM (DPCP/HPβCD) at lower doses compared to that in 3DGM (DPCP/β-CD), indicating that the HPβCD derivatives were more effective in enhancing the anti-inflammatory properties of DPCP., Competing Interests: The authors declare that this study received β-cyclodextrin from Cyclo Chem Co., Ltd., which was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Inoue, Yoshino, Kudo, Kodama, Moteki and Kimura.)

Background: Contact immunotherapy using diphenylcyclopropenone (DPCP) is a recommended treatment for severe alopecia areata (AA); however, few clinical factors are known, and few standardized application methods affecting therapeutic efficacy have been devised., Objective: To confirm the therapeutic response of DPCP immunotherapy in AA, first we analyze the factors influencing its outcome and patient satisfaction levels, after which we standardize the DPCP treatment method for better outcomes., Methods: We utilized a nationwide questionnaire-based survey to assess patient satisfaction and undertook a medical record review involving 412 patients currently undergoing treatment for DPCP., Results: The patients' mean age was 36.4 years, and 27% of the cases were diagnosed as AA in childhood. Treatment response was higher when DPCP was used to treat the entire scalp, including subclinical lesions, and longer treatment durations and longer intervals between treatments were associated with a better treatment response. Atopy (atopic dermatitis, allergic rhinitis and bronchial asthma), thyroid disorder, and extent of hair loss were all negatively correlated with the treatment response. However, there was no correlation between the treatment response and factors such as the age of onset, a family history of AA, nail changes, or AA duration, which are commonly known to be associated with a poor prognosis., Conclusion: DPCP immunotherapy is an effective treatment for AA, and the study demonstrated the factors affecting DPCP treatment response and patients' satisfaction and may contribute to standardizing the DPCP treatment method for better outcomes., Competing Interests: The authors have nothing to disclose., (© 2024 The Korean Dermatological Association and The Korean Society for Investigative Dermatology.)

Immunotherapy by diphenylcyclopropenone (DPCP) is generally started with 2% DPCP sensitization, however in recent years studies have questioned the necessity of sensitization that may cause patients severe reactions and troubles at the onset of therapy. The purpose of the present study was to evaluate the association between the severity of initial reaction to 2% DPCP sensitization in AA patients and clinical response. In this retrospective study, 110 AA patients who continued therapy for at least 6 months were enrolled. Hair loss and hair regrowth rates were calculated based on the Severity of Alopecia Tool (SALT) scoring system. Initial reaction to 2% DPCP sensitization after 2 weeks was graded as negative reaction (absence of any reaction), doubtful reaction (mild erythema, pruritus, and irritation for minutes after test), weak (erythema, mild edema, and scaling), and strong to extreme reaction (vesicles, bullae, ulcer, and discharge). The degrees of the initial reaction to 2% DPCP after 2 weeks were negative reaction 13 (11.81%), doubtful reaction 40 (36.36%), weak reaction 33 (30%), and strong to extreme reaction 24 (21.81%). Patients were divided into two groups: (A) patients with less than 12‐month therapy (75 of 110), (B) patients with more than 12‐month therapy (35 of 110). Initial reaction to 2% DPCP sensitization was not correlated with hair regrowth rate in either group (group A: Spearman's rho = 0.194, p = 0.095; group B: Spearman's rho = 0.063 p = 0.720). After 12‐month treatment with DPCP, hair regrowth rate was significantly greater than 6‐months therapy (group A: 17.03 ± 37.78, group B: 49.26 ± 36.34; p = 0.003). The severity of hair loss at the onset of treatment was significantly associated with the response rate in both groups (p‐value <0.002). Based on our results, it is the initial severity of the disease and not the initial reaction to 2% DPCP sensitization that predicts the clinical response to DPCP immunotherapy. [ABSTRACT FROM AUTHOR]

Objective: Palmar verrucae are often recalcitrant to treatment. Diphenylcyclopropenone (DPCP) and Nd:YAG laser are treatment modalities that may be used in cases which are resistant to conventional treatment modalities. The aim of this study is to compare the treatment efficacies and safety of DPCP and Nd:YAG laser in the treatment of palmar verrucae. Material and Methods: A total of 30 patients with single or multiple palmar verrucae were divided into two equal groups: DPCP group and the Nd:YAG group with 15 patients in each. Informed consent of each patient was taken before treatment. Pretreatment photos of each patient were taken. The age, gender, location and number of lesions of each patient were noted. One group received monthly Nd:YAG treatments and the other group received weekly DPCP treatments until complete remission. Results: The mean number of sessions required for remission was 1.6 in the Nd:YAG group and 4 in the DPCP group. Nd:YAG treatment requires a statistically significantly lower number of treatment sessions compared to DPCP treatment (p<0.05). The mean treatment duration was 6.4 weeks for the Nd:YAG group and 4 weeks for the DPCP group. A statistically significant difference was found between the two groups in terms of treatment duration the patients achieved complete remission in the DPCP group faster than the Nd:YAG group (p=0.005). Conclusion: Our study has shown that DPCP is a faster modality than Nd:YAG in the treatment of palmar verrucae. On the other hand, Nd:YAG is more effective per treatment session and therefore requires less hospital visits than Nd:YAG. The treatment efficacy was independent of the patient’s age and number of lesions. DPCP was better tolerated than Nd:YAG. [ABSTRACT FROM AUTHOR]

Anogenital warts are caused by human papillomavirus types 6 and 11. They are rare in children, and treatment is difficult since conventional treatments are generally painful and require the patient to be anesthetized. Topical diphenylcyclopropenone (DPCP) is a contact immunotherapy used for treatments of recalcitrant warts and alopecia areata. We herein report 3 cases of anogenital warts in children successfully treated with topical DPCP. Our results suggest that topical DPCP may be a valuable option for the treatment of anogenital warts in children who have difficulty with painful destructive therapy.

Efficacious and safe treatments are lacking for cutaneous leishmaniasis (CL). This study investigates the efficacy of adding diphencyprone immunotherapy to conventional meglumine antimoniate (MA) treatment for acute urban CL. This randomized controlled pilot study included 46 patients with acute CL. They were randomly allocated to receive either combination of diphencyprone immunotherapy with intralesional MA (intervention; N = 23) or intralesional MA alone (control; N = 23) weekly. The size and duration of lesions were measured at the baseline and after that at 4th, 8th, 12th, and 24th weeks. Data were analyzed in SPSS and p <.05 was considered significant. The groups showed no significant difference in duration of lesions, but number of injections was significantly higher in the control group compared with the intervention group (p <.001). Size and induration of lesions was significantly reduced in both groups during the course of study (p <.001). The intervention group showed significantly lower induration of lesions in 4th, 8th, and 12th week compared with controls (p <.05). Combination of diphencyprone with MA resulted in earlier resolution of acute CL lesions with a relatively acceptable rate of adverse effects, compared with intralesional MA alone. [ABSTRACT FROM AUTHOR]

Topical immunotherapy with diphenylcyclopropenone (DPCP) is considered to be the most effective treatment of severe AA. However, the mechanism is unclear and an early predictor for the efficacy needs to be explored. The TSLP/OX40L/IL‐13 pathway is an important pathway to initiate and maintain Th2 immune responses. Our previous work suggests this pathway may play a role in severe AA treated with DPCP. Thus, to further investigate the mechanism of TSLP/OX40L/IL‐13 pathway in severe AA treated with DPCP and explore the predictor for the efficacy of DPCP therapy, we conducted a prospective study to compare expression levels of TSLP, OX40L, Th2 cytokines IL‐4, IL‐5 and IL13, and Th1 cytokine IFN‐γ in severe AA patients before and after the treatment. Results showed that 21 AA patients were responsive (responders) to the DPCP therapy and 12 were not responsive (non‐responders). Responders had lower levels of TSLP, OX40L and IL‐13 than non‐responders before the treatment. After the DPCP treatment, TSLP, IL‐5 and IL‐13 increased and IFN‐γ decreased in responders while there were no changes of TSLP, IL‐4, IL‐13 and IFN‐γ in non‐responders. Our data suggest that the TSLP/OX40L/IL‐13 pathway is down‐regulated in some severe AA patients and DPCP might play a therapeutic role by up‐regulating the pathway in these severe AA patients. The TSLP/OX40L/IL‐13 pathway could be a predictor of response to the DPCP therapy for severe AA patients. [ABSTRACT FROM AUTHOR]

Treatment of alopecia totalis and alopecia universalis is often challenging and unsatisfactory. Recently, Janus kinase inhibitor has shown promising results. The aim of this study is to compare the efficacy and tolerability of oral tofacitinib and conventional modalities for treating refractory alopecia totalis/universalis. A total of 74 patients (18 treated with tofacitinib, 26 treated with conventional oral treatment (steroid ± cyclosporine), and 30 treated with diphenylcyclopropenone) were included in the study. The patients’ medical records were reviewed retrospectively. After 6 months, 44.4% of patients in the tofacitinib group, 37.5% in the conventional oral treatment group, and 11.1% in the diphenylcyclopropenone group achieved 50% improvements in the Severity of Alopecia Tool score. During treatment, 10% of patients in the tofacitinib group, 73.1% in the conventional oral treatment group, and 10% in the diphenylcyclopropenone group experienced adverse drug reactions. In conclusion, oral tofacitinib was more effective than diphenylcyclopropenone immunotherapy and more tolerable than conventional oral treatment after 6 months of treatment.

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Although the development of successful vaccines against coronaviruses may be achieved, for some individuals the immune response that they stimulate may prove to be insufficient for effective host defence. The principle that a relatively strong contact allergen will have an enhancing effect on sensitization compared with a less potent contact allergen if they are co‐administered, may not, at first, appear relevant to this issue. However, this augmentation effect is thought to be due to the sharing of common or complementary pathways. Here, we briefly consider aspects of the shared and complementary pathways between skin sensitization induced by exposure to a contact allergen and the immune response to viruses, with particular reference to COVID‐19. The relationship leads us to explore whether this principle, which we name here as "co‐operative immune augmentation" may be extended to include viral vaccination. We consider evidence that even relatively weak contact allergens, used in vaccines for other purposes, can show enhanced sensitization, which is in keeping with a co‐operative augmentation principle. Finally, we consider how the potent contact allergen diphenylcyclopropenone could be employed safely as an enhancer of vaccine responses. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is a chronic and inflammatory disease of hair follicles, causing nonscarring alopecia. While the various types of treatment have been investigated, the definite cure for AA has not been established yet. Objectives: The objective of this study is to evaluate the clinical and dermoscopic features of patients with AA to identify the factors with prognostic values in diphenylcyclopropenone (DPCP) response rate. Methods: Eighty patients with AA were included, and baseline hair loss was calculated based on the severity alopecia tool (SALT) score. The characteristic dermoscopic features of AA were evaluated by two skilled dermatologists separately at baseline, 12 and 24 weeks afterward. Results: The mean SALT score in the 1st, 12th, and 24th week was 77 ± 24.7, 80 ± 27, and 71 ± 35.6, respectively, which were not significantly different over this time period (P = 0.085). SALT score correlated negatively with the short vellus hair/field (ρ = -0.361, P = 0.02), broken hair/field (ρ = -0.317, P = 0.044), and tapering hair/field (ρ = -0.388, P = 0.012) in the 1st week. Forty‑one patients continued treatment courses over 24 weeks. Six patients had good response, 11 achieved partial response, and 24 had no hair regrowth. Statistically significant correlation was observed between treatment response and duration of disease (P = 0.04), frequency of relapses (P = 0.033), type of alopecia, and number of black dots (P = 0.028). The mean for all dermoscopic findings showed descending process during our three follow‑up sessions which was statistically significant for black dot (P = 0.015) and broken hair (P = 0.006). Conclusion: The number of black dot per field initially was negatively correlated to DPCP therapy and the frequency of dermoscopic findings reduced during the treatment process. [ABSTRACT FROM AUTHOR]

Background: This study investigated predictors of response to topical diphenylyclopropenone (DPCP) immunotherapy in patients with alopecia areata (AA). Objective: To identify predictors of response, or resistance, to treatment for AA through clinical observations and serum tests. Methods: Eighty four AA patients were treated with DPCP. Serum cytokine levels were measured in 33 AA patients pre‐ and post‐treatment, and in 18 healthy controls, using ELISA assays. Results: Of patients, 56.1% responded to DPCP with satisfactory hair regrowth; the response rate was negatively correlated with hair loss extent. Before DPCP treatment, higher serum IFN‐γ and IL‐12 cytokine levels were observed in AA patients compared to healthy controls. Non‐responders to DPCP had significantly elevated serum IL‐4 pre‐treatment (3.07 fold higher) and lower IL‐12 levels compared with responders. After DPCP treatment, non‐responders had persistently high IL‐4, increased IL‐12, negligible decrease in IFN‐γ and decreased IL‐10. Post‐treatment DPCP responders exhibited significantly decreased IFN‐γ and IL‐12, and increased IL‐4 and IL‐10. Development of adverse side‐effects was significantly associated with higher pre‐treatment serum IgE levels. Limitations: A small number of subjects were evaluated. Conclusions: Potentially, elevated pre‐treatment serum levels of IL‐4 and IL‐12 can be used as unfavorable and favorable predictors of DPCP therapeutic effect, respectively. In addition, pre‐treatment elevated serum total IgE may predict increased risk for severe adverse side‐effects to DPCP application. Whether serum cytokine expression levels can be used as predictors of response to other forms of treatment is unknown, but it may warrant investigation in the development of personalized treatments for AA. [ABSTRACT FROM AUTHOR]

This report surveys the role of topical and intralesional agents in the management of in-transit melanoma. The extent and progression of in-transit disease is highly variable and many patients can have a protracted period of locoregional control. These agents are useful in the management of patients who have progressed beyond local surgical excision in whom more aggressive therapies, such as isolated limb infusion or use of talimogene laherparepvec, are not appropriate or have failed. In general, these agents are modestly effective and associated with frequent but only minor toxicity. As the mechanism of action of many of these agents includes initiation of a local immune response, combinations with immune checkpoint inhibitors are currently being explored.

Contact immunotherapy with diphenylcyclopropenone (DPCP) and anthralin is considered the treatment option for extensive alopecia areata (AA) unresponsive to DPCP immunotherapy alone. Only one study has described the efficacy of combination therapy; therefore, we investigated whether topical DPCP and anthralin can promote hair regrowth in DPCP-non responders. In this retrospective case-series we analyzed the efficacy and side effects of DPCP with anthralin in AA patients who did not respond to several months of treatment with DPCP alone. Thirty-two DPCP-nonresponsive AA patients were treated with DPCP and anthralin for the average of 8.3 ± 3.8 (3–17) months. During the treatment, 40.62% of patients (13 patients out of 32) had terminal hair regrowth. The mean of hair regrowth rate was 41%; it was mainly as partial hair regrowth (˂ 50%) and 27.27% of cases achieved > 50% terminal hair regrowth. Treatment response strongly related to the duration of combination therapy (p value ˂ 0.001), but we did not find any relation with other demographic characteristics. The first signs of response to treatment were noticed 2–12 months (5.5 ± 3.4) after initiation of combination therapy while there was a positive correlation among the duration of treatment and percentage of hair regrowth (p < 0.001). The most common complication was bullae (25%), and the least frequent side effect was generalized pruritus (3.1%). The combination therapy with DPCP and anthralin could be effective to treat DPCP non-responder AA patients. Additionally, the higher treatment response could be achieved by longer treatment duration. [ABSTRACT FROM AUTHOR]

Anogenital warts are caused by human papillomavirus types 6 and 11. They are rare in children, and treatment is difficult since conventional treatments are generally painful and require the patient to be anesthetized. Topical diphenylcyclopropenone (DPCP) is a contact immunotherapy used for treatments of recalcitrant warts and alopecia areata. We herein report 3 cases of anogenital warts in children successfully treated with topical DPCP. Our results suggest that topical DPCP may be a valuable option for the treatment of anogenital warts in children who have difficulty with painful destructive therapy. [ABSTRACT FROM AUTHOR]

Background: Bovine colostrum (COL) has been advocated as a nutritional countermeasure to exercise-induced immune dysfunction, but there is a lack of research with clinically relevant in vivo measures.Aim: To investigate the effects of COL supplementation on in vivo immunity following prolonged exercise using experimental contact hypersensitivity (CHS) with the novel antigen diphenylcyclopropenone (DPCP).Methods: In a double-blind design, 31 men were randomly assigned to COL (20 g/day) or placebo (PLA) for 58 days. Participants ran for 2 h at 60% maximal aerobic capacity on day 28 and received a primary DPCP exposure (sensitisation) 20 min after. On day 56, participants received a low-dose-series DPCP challenge to elicit recall of in vivo immune-specific memory (quantified by skinfold thickness 24 and 48 h later). Analysis of the dose-response curves allowed determination of the minimum dose required to elicit a positive response (i.e., sensitivity).Results: There was no difference in summed skinfold thickness responses between COL and PLA at 24 h (p = 0.124) and 48 h (p = 0.405). However, sensitivity of in vivo immune responsiveness was greater with COL at 24 h (p < 0.001) and 48 h (p = 0.023) with doses ~ twofold greater required to elicit a positive response in PLA.Conclusions: COL blunts the prolonged exercise-induced decrease in clinically relevant in vivo immune responsiveness to a novel antigen, which may be a mechanism for reduced illness reports observed in the previous studies. These findings also suggest that CHS sensitivity is highly relevant to host defence. [ABSTRACT FROM AUTHOR]

Treatment of alopecia totalis and alopecia universalis is often challenging and unsatisfactory. Recently, Janus kinase inhibitor has shown promising results. The aim of this study is to compare the efficacy and tolerability of oral tofacitinib and conventional modalities for treating refractory alopecia totalis/universalis. A total of 74 patients (18 treated with tofacitinib, 26 treated with conventional oral treatment (steroid ± cyclosporine), and 30 treated with diphenylcyclopropenone) were included in the study. The patients' medical records were reviewed retrospectively. After 6 months, 44.4% of patients in the tofacitinib group, 37.5% in the conventional oral treatment group, and 11.1% in the diphenylcyclopropenone group achieved 50% improvements in the Severity of Alopecia Tool score. During treatment, 10% of patients in the tofacitinib group, 73.1% in the conventional oral treatment group, and 10% in the diphenylcyclopropenone group experienced adverse drug reactions. In conclusion, oral tofacitinib was more effective than diphenylcyclopropenone immunotherapy and more tolerable than conventional oral treatment after 6 months of treatment. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is a skin disease of unclear etiology. In AA, topical immunotherapy with diphenylcyclopropenone (DPCP) is considered the most effective treatment; however, the most common therapies give unsatisfactory results. Aim: To assess the efficacy of a topical application of a solution of DPCP based on the intensity, duration and number of exacerbations of AA and to compare the efficacy of two treatment regimens. Material and methods: In this prospective study, 39 patients with AA were enrolled. Group A was treated at weekly intervals and group B at 3-week intervals. Hair loss was assessed by independent dermatologists and documented by photography and dermoscopy. Results: After 6 months' therapy, hair regrowth greater than 50% was observed in 21 patients, while worsening, no regrowth, or regrowth of less than 50% was seen in 18 patients. Regrowth exceeding 50% of initial loss was observed in 12 of 17 patients with baseline hair loss < 50%, in 9 of 22 patients with severe alopecia, and in 4 of 9 patients with alopecia totalis. Both groups showed significant improvement with higher efficacy in group B (54%) than group A (46%). Conclusions: Treatment at longer intervals may be safer and more comfortable for patients; however, further research is required. [ABSTRACT FROM AUTHOR]

We studied ultrafast photodissociation reaction of diphenylcyclopropenone (DPCP) in solution by time-resolved impulsive stimulated Raman spectroscopy (TR-ISRS) using sub-6-fs pulses. The obtained femtosecond time-resolved Raman data of excited-state DPCP did not show any noticeable spectral change during its lifetime of 180 fs. This indicates that photoexcited DPCP is trapped at the excited-state potential energy minimum before undergoing the photodissociation, which is consistent with the predissociation picture of ultrafast photodissociation reaction of DPCP. The present study demonstrates the high capability of TR-ISRS for structural characterization of short-lived reactive transients that decay within only a few hundreds of femtoseconds. [ABSTRACT FROM AUTHOR]

Aims: To quantify the anti‐inflammatory potency of topical corticosteroids and topical calcineurin inhibitors by measuring the contact allergic response to a diphenylcyclopropenone (DPCP) challenge in de novo sensitized human volunteers. Methods: Two randomized, double‐blind, vehicle‐controlled studies were performed encompassing 76 volunteers: 29 in the first and 47 in the second study. Topical drugs were applied pre‐ and/or post‐treatment in block designs. The compounds were tested simultaneously under occluded patch tests covering DPCP‐induced dermatitis. Inhibitory responses were assessed by visual scoring and measurements of the oedema thickness with ultrasound. Results: When applied both before and after the DPCP challenge, significant anti‐inflammatory effects were seen in descending order for tacrolimus 0.1% ointment, clobetasol propionate ointment, betamethasone valerate ointment and hydrocortisone butyrate ointment, while pimecrolimus cream, hydrocortisone ointment and vehicles had no significant effect. Only tacrolimus ointment (P < 0.01) demonstrated a consistent significant pre‐treatment inhibitory effect compared with an untreated DPCP control. Conclusions: This human testing method in which the inflammation of experimentally induced allergic patch test reactions is quantified by objective measurement allows an analysis of the anti‐inflammatory potency of not only topical corticosteroids, but also of drugs that have no effect on vasoconstriction. The method allowed comparison of the potencies of four topical corticosteroids and two calcineurin inhibitors. [ABSTRACT FROM AUTHOR]

Background: Diphenylcyclopropenone (DPCP) immunotherapy for viral warts has been used for many years, but no studies have analyzed the treatment effects of DPCP alone, without the use of conventional therapy before immunotherapy. Objectives: We evaluated clinical efficacy of DPCP monotherapy compared to cryotherapy and pulsed dye laser (PDL) therapy. We also assessed the impact of initial sensitization on clinical response. Methods: We retrospectively analyzed the medical records of 250 patients with multiple viral warts between January 2008 and December 2015. Results: The DPCP-only group (n = 43) showed a lower clinical response (75.6%) than the cryotherapy-only group (n = 171, 89.8%, P < .01) and PDL-only group (n = 36, 90.3%, P < .01). The positive clinical response was 76.3% (119/156) in the successful sensitization group (n = 21) and 74.4% in the failed sensitization group (P = .870). Conclusions: DPCP monotherapy has a lower clinical response than conventional therapy. Initial sensitization to DPCP does not predict a failed response with continued immunotherapy for viral warts. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata is an autoimmune disease, as a non-scarring hair loss and is without clinical signs. Although spontaneous recovery occurs in many patients with alopecia areata, but a lot of patients suffer from chronic periods of the disease. And according to the related serious complications of corticosteroid treatment and high relapse rate, finding alternative effective treatment for these patients by dermatologists is still ongoing. Methods: 50 patients with alopecia areata scalp during the last 3 months, who had no response to treatment with corticosteroids, were enrolled in two equal groups. One group received therapy with topical Diphenylcyclopropenone (DPCP) and the other group was treated with topical Anthralin. (IRCT: 201410113566N5). Results: Patients in the two groups in terms of gender, age, extent and duration of the current period scalp disease were not significantly different. No significant difference was observed in treatment response between the two groups (P=0.189). Age, as the only prognostic factor in treatment DPCP was found (P=0.047) and any prognostic factor in Anthralin group not found. More complications was seen in Anthralin group compared to the DPCP group (P=0.018). The duration of treatment and relapse rate, there was no significant difference between the two treatment groups. Conclusion: Even better effect using DHCP in alopecia areata, but no significant difference Anthralin. But according to fewer side effects in DPCP and better effect on younger ages, this drug can be used as alternative treatment for resistant alopecia areata of children. [ABSTRACT FROM AUTHOR]

Diphenylcyclopropenone (DPCP) is an effective topical immunotherapy for recalcitrant alopecia areata (AA), which sometimes requires prolonged treatment. We developed a new treatment protocol to shorten the duration of therapy. This study aimed to compare the efficacy and safety of the new treatment protocol with the standard treatment protocol in the treatment of recalcitrant AA. We conducted a 6-year retrospective comparative study of patients with AA who received one of the DPCP treatment protocols at our institute. Patients’ information was collected and subsequent statistically analyzed. Thirtynine patients (16 in the new treatment group and 23 in the standard treatment group) were included. There were no statistically significant differences in area of hair regrowth. Mean duration to initial hair regrowth and mean duration to significant hair regrowth in the new treatment group were significantly shorter than in the standard treatment group (P=0.002 and 0.01, respectively). Adverse effects were slightly higher in the new treatment group. The present study reveals the effectiveness and safety of the new treatment protocol, which shortens the duration of DPCP treatment and could represent an alternative regimen.

Alopecia areata (AA) is a T cell-mediated autoimmune disease involving hair follicles characterized by hair loss. 2,3-diphenylcyclopropenone (DCP) is a topically administered drug intended for treating AA. The study investigates an efficacy and safety of DCP for the purpose of the treatment of AA. It presents a comparative study of two formulas: DCP in propylene glycol and DCP in isopropanol. While the treatment efficacy in both groups was very simmilar, the tolerance of the DCP in isopropanol was better than DCP in propylene glycol. Authors indicate the potential clinical applications of latter formula.

The topical contact sensitiser diphenylcyclopropenone ( DCP) remains one of the most effective treatment modalities for alopecia areata ( AA). However, some patients (nonresponders) do not respond to this treatment because they do not have an allergic reaction to DCP. The aim of this study was to investigate the potential role of imiquimod in inducing an allergic reaction to DCP in nonresponders. In all, 20 nonresponders were recruited from a group of DCP-treated AA patients. Of these patients, 10 were treated with DCP and topical imiquimod and 10 were treated with DCP alone. A significantly better therapeutic outcome was measured in the DCP plus imiquimod group than in the group treated with DCP alone. The potential mechanism of imiquimod may involve the role of interleukin-12, as previously suggested in an animal model. These findings suggest that imiquimod may have the potential to improve prognosis in nonresponder AA patients treated with DCP. [ABSTRACT FROM AUTHOR]