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Treatment of chronic severe alopecia areata with topical diphenylcyclopropenone and 5% minoxidil: a clinical and immunopathologic evaluation.

AbstractBACKGROUND:
Topical diphenylcyclopropenone (DPCP) and minoxidil have been used in the treatment of alopecia areata with variable results.
OBJECTIVE:
This study was designed to evaluate the efficacy of DPCP alone or in combination with topical 5% minoxidil for the treatment of chronic severe alopecia areata. The effect of therapy on cutaneous T-cell and Langerhans cell subpopulations and intercellular adhesion molecule-1 (ICAM-1) expression was also examined.
METHODS:
Fifteen patients with chronic (more than 2 years), severe (more than 50% scalp involvement) alopecia areata participated in a 24-week trial. Half of the scalp was treated with DPCP once weekly and with either 5% minoxidil solution or a vehicle solution twice daily in a randomized double-blind design. Skin biopsy specimens from each half of the scalp were obtained before therapy and after 12 and 24 weeks of therapy for histologic and immunophenotypic analysis.
RESULTS:
Thirteen patients completed the study. Five of 13 patients (38%) showed marked regrowth of coarse terminal hair after 24 weeks of treatment with DPCP. The addition of topical 5% minoxidil did not produce any significant clinical benefit in this 24-week trial. Immunophenotypic analysis showed no differences between responders and nonresponders at baseline. During treatment, Leu-4, Leu-2, Leu-3, and keratinocyte ICAM-1 expression were significantly reduced in biopsy specimens of responders versus nonresponders.
CONCLUSION:
DPCP treatment showed a 38% success rate in producing cosmetically acceptable regrowth in patients with chronic severe alopecia areata.
AuthorsJ Shapiro, J Tan, V Ho, F Abbott, V Tron
JournalJournal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 29 Issue 5 Pt 1 Pg. 729-35 (Nov 1993) ISSN: 0190-9622 [Print] UNITED STATES
PMID7901248 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal
  • Antigens, CD
  • Antigens, CD4
  • Antigens, CD8
  • Cell Adhesion Molecules
  • Cyclopropanes
  • Intercellular Adhesion Molecule-1
  • Minoxidil
  • diphenylcyclopropenone
Topics
  • Administration, Cutaneous
  • Adult
  • Aged
  • Alopecia (drug therapy, immunology, pathology)
  • Antibodies, Monoclonal
  • Antigens, CD (biosynthesis, drug effects)
  • Antigens, CD4 (biosynthesis, drug effects)
  • Antigens, CD8 (biosynthesis, drug effects)
  • Cell Adhesion Molecules (biosynthesis, drug effects)
  • Chronic Disease
  • Cyclopropanes (therapeutic use)
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunophenotyping
  • Intercellular Adhesion Molecule-1
  • Keratinocytes (drug effects, metabolism)
  • Langerhans Cells (drug effects, metabolism)
  • Male
  • Middle Aged
  • Minoxidil (therapeutic use)
  • Severity of Illness Index
  • T-Lymphocyte Subsets (drug effects, metabolism, pathology)

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