Abstract
Diphencyprone (DCP) is a contact sensitizer which is used to treat dermatological disorders with an immunological origin, such as extensive alopecia areata (AA). Vitiligo is a rare but known side effect of DPCP therapy which is formed in the treatment site or remote areas. In this paper a 37-year-old man developed alopecia totalis with loss of eyebrows and eyelashes who presented some vitiligo patches on his scalp and arm distant from the location of DPCP application and a 42-year-old woman with 25 years history of hair loss and 3 months DPCP application who revealed some vitiligo patches on the scalp with distant to the site of application at the 6th week are reported. Considering the absence of personal and family history of Vitiligo in our two cases, the hypothesis of latent Vitiligo is not proved. The positive patch test in left arm of one of the patients also suggests the direct role of DPCP as the cause of Vitiligo occurrence. As the development of vitiligo by DCP is unpredictable and the depigmentation may persist indefinitely, it is important to inform all patients about this potential adverse effect before starting the treatment.
Highlights
Alopecia areata (AA) is one of the most frequently organrestricted diseases, characterized by non-scarring hair loss, considered to be an autoimmune disorder [1] and approximately occurs in 2% of the population [2]
It has been proposed that different T cells migrate to the treated area which increase the clearance of the follicular antigen [3] predicting 100% response rate for patients with 26% to 49% hair loss, 88% for patients with 50% to 74% hair loss, 60.3% for patients with 75 to 99% hair los,s and 17.4% for patients with AA totalis/universalis [9]
The treatment of patients suffering from AA with diphenyl cyclopropenone (DPCP) presents high response rates similar to those reported by previous studies, the potential risk of vitiligo must be considered
Summary
Alopecia areata (AA) is one of the most frequently organrestricted diseases, characterized by non-scarring hair loss, considered to be an autoimmune disorder [1] and approximately occurs in 2% of the population [2]. Topical irritants, photochemotherapy (PUVA), contact immunotherapy, and biological drugs [3]. Contact sensitizers include dinitrochlorobenzene (DNCB), diphenyl cyclopropenone (DPCP), and squaric acid dibutyl ester (SADBE). Vitiligo is one of the undesirable and rare adverse effects of topical sensitizers [5]. This complication has become a principal challenge to the dermatologists due to its Resistance to treatment [5]. DPCP is considered the most effective treatment of AA with success rates ranging from 4% to 85% [7]. Two cases of AA who developed vitiligo after treatment with DCPC are introduced
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