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

Abstract

BACKGROUND:

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.

• Authors: J Shapiro, J Tan, V Ho, F Abbott, V Tron
• Journal: Journal 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
• PMID: 7901248 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antigens, CD
• CD4 Antigens
• CD8 Antigens
• 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)
• CD4 Antigens (biosynthesis, drug effects)
• CD8 Antigens (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)