Background: Topical immunotherapy with diphencyprone (DPCP) for the treatment of severe alopecia areata has been used since 1983 and is felt to be the treatment of choice for chronic extensive alopecia areata. Highly variable results have been reported. The purposes of this study were to evaluate the efficacy of DPCP in the treatment of chronic, extensive alopecia areata and to assess the long-term overall benefit of treatment.
Methods: In a retrospective study, 54 patients with chronic extensive alopecia areata who had used DPCP for more than 1.5 years between 2001 and 2005 were studied. Patients' information and results of treatment after every session were collected from record files.
Results: The response to treatment was excellent (76-100% terminal hair re-growth) in 40.7%, good (51-75% terminal hair re-growth) in 14.8%, moderate (26-50% terminal hair re-growth) in 14.8%, and mild (1-25% terminal hair re-growth) in 29.6% of patients. However, 33% of them had a relapse. The response to treatment was excellent and good in 62% of the patients with less than 10 years duration of alopecia areata, but in the group with the duration of more than 10 years, a good and/or excellent response was found in 25% of patients and 75% had a poor and/or moderate response (P=0.017). There was no relationship between response to treatment and sex, onset of disease, nail involvement, atopy, extent of hair loss, and family history of alopecia areata.
Conclusion: Topical immunotherapy with DPCP has proved to be an effective treatment with prolonged therapeutic results in Iranian population. Duration of disease less than 10 years is a main predictor for a good response rate.