A Journal Review

EFFICACY OF DIPHENYLCYCLOPROPENONE IN
ALOPECIA AREATA:
A COMPARISON OF TWO TREATMENT
REGIMENS.
P R E S E N TAT O R :
M U H A M M A D FA Q I H
N U R FA D I L L A H P U T R I S E P T I A N I

PRECEPTOR:
D R . R E S AT I N A N D O PA N O N S I H , S P. K K
 INTRODUCTION
• Alopecia areata (AA) is a skin disease of unclear etiology although
immunologic, genetic, and environmental factors may play an important role
in the development of permanent or temporary hair loss.

• Foci of baldness are usually oval and may be of different sizes.

• The disease usually affects the scalp.

“Clinically, the skin within the affected

areas remains normal”.
• To e v a l u a t e t h e e f f i c a c y o f D P C P i n p a t i e n t s w i t h
AA
• To a s s e s s w h e t h e r t h e e f f i c a c y d e p e n d s o n t h e
severity and duration of the disease and the
number of exacerbations
• To c o m p a r e t h e d i f f e r e n c e s i n e f f e c t s b e t w e e n a
weekly application and an every-21-day
application.

AIM
 • Prospective Study
• The study includes 39 patients suffering from AA

PA R T I C I PA N T S
• 39 Patients (23 women, 16 men)
• Mean age 37,5 years
• Divided into 2 groups
⚬ Group A (treated at weekly intervals)
⚬ Group B (treated at 3-week intervals)

S TAT I S T I C A L A N A LY S I S
Statistical analysis was carried out with Statistica software
v 1 0 ( S t a t S o f t , Tu l s a , O K , U S A ) .

The data were presented as means and percentages. MATERIAL

& METHODS
Associations between risk factors and treatment results
w e r e a s s e s s e d b y S p e a r m a n ’s r a n k c o r r e l a t i o n c o e f f i c i e n t .
The criteria for statistical significance were set at
p < 0,05.
 RESULTS

I n t h e s t u d y g r o u p , t h e m e a n h a i r l o s s a t b a s e l i n e w a s 5 4 . 3 % . T h e b i g g e s t g r o u p s a c c o r d i n g t o S A LT
were S1, with 8 patients having less than 25% of their scalp affected, and S 5, with 9 patients
displaying alopecia totalis. After 6 months of treatment, hair regrowth greater than 50% was
observed in 21 patients, while worsening, lack of regrowth, or regrowth of less than 50% was seen
in 18 patients.

In 17 patients with baseline hair loss <50%, regrowth exceeding 50% of initial loss was obser ved in
12 patients, while it was below 50% in 5 of them. In 22 patients with severe alopecia (>50%),
regrowth exceeding 50% occurred only in 9 cases. In 9 patients with alopecia totalis, regrowth
exceeding 50% was observed in 4 cases.
RESULTS
GROUP A (16 Patients, weekly GROUP B (23 Patients, applications
applications) every 21 days)

• worsening, lack of regrowth, or regrowth of • worsening, lack of regrowth, or regrowth of

less than 50% was observed in 8 patients less than 50% was observed in 10 patients
• hair regrowth greater than 50 % was • hair regrowth greater than 50 % was
observed in 8 patients observed in 13 patients

“The mean response rate in group “The mean response rate in group
A was 46%” A was 54%”

"Group B has higher efficacy than group A"

RESULTS

Exp : S0 (no hair loss) ; S1 (hair loss of <25 %); S2 (hair loss of 25 – 49%); S3 (hair loss of 50 – 74%); S4 (hair loss of (75 – 99 %) ; and
S5 (hair loss of 100 %)
 DISCUSSION
A topical solution of DPCP is often used in patients suffering from treatment-resistant AA and in those with more
than 50% hair loss. In the present study, the efficacy of DPCP was confirmed in patients with different severities
of AA. Additionally, treatment at longer intervals (21 days vs. 7 days) appeared to give better results and to
increase comfort and safety.

To date, three contact allergens have been used in the treatment of AA:
• Dinitrochlorobenzene (DNCB),
• Squaric acid dibutylester (SADBE), and
• DPCP.
Due to the mutagenic properties of DNCB and the lack of chemical stability of SADBE, DPCP remains the most
frequently used immunomodulator. Treatment with DPCP starts after an initial sensitization with a 2% solution of
this agent. Next, a solution of low DPCP concentration is applied in increasing doses on the skin of the scalp until
contact eczema appears
 CONCLUSION

• Treatment of AA based on DPCP may be considered a good therapeutic option, especially in

patients with extensive baldness.

• High efficacy and easy application as well as its rare and mild side effects.
• Treatment at longer intervals may be more effective, safer and more comfortable for the patients.

• Further research is required.

T H A N K YO U
Any questions?