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Abstract
Advances in understanding of basic immunology and parallel technical advances have opened the door to new and exciting immunological therapies such as etanercept, rituximab, imiquimod and diphencyprone. Thus the aim of this work was to review the literature for the various modalities of immunotherapy and the potential uses and benefits in common dermatologic diseases and in alopecia areata. We also aimed to determine clinically the efficacy of the contact immune sensitizer diphencyprone (DPCP) in the treatment of severe or resistant alopecia areata.
Eight male patients above 18 years old with resistant and progressive alopecia areata were treated with topical contact sensitizer DPCP for a period of 6 months. They were first sensitized with DPCP 2% in acetone. Two weeks following sensitization they were treated with topical DPCP in acetone with low concentration (0.001%) applied twice weekly to be increased if necessary to maintain a mild degree of eczema. A good clinical response was achieved in only 2 patients treated with DPCP, showing acceptable terminal hair growth. Few terminal hair regrowth was observed in another 2 patients whereas no response at all occurred in the remaining 4 cases suffering from AA totalis or universalis. Thus we conclude that DPCP may consider as an accepted therapeutic modalities, in the treatment of severe patchy alopecia areata, especially if used for prolonged duration. It does not seem to be of benefit in cases of alopecia totalis or universalis.
Key word: Immunotherapy, Diphenylcyclopropenone, Biological therapies, Immune response modifiers and Alopecia areata.