Diphenylcyclopropenone Treatment Outcomes for Alopecia Areata

Abstract

Objective: To ascertain (1) Diphenylcyclopropenone (DCP)’s efficacy in treating alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) in Thai patients; and (2) prognostic factors. Materials & Methods: We retrospectively reviewed the medical records of patients with AA, AT, and AU who were administered DCP at Siriraj Hospital, Bangkok, Thailand. The median response and relapse times of the 3 groups were evaluated. Factors affecting outcomes were investigated. Results: Fifty-nine cases were enrolled (AA, 22; AT, 9; AU, 28), with women predominating in each group. The overall response was 61% (AA, 78.6%; AT, 66.7%; AU, 50%). The median response time was 58 weeks, with a significantly longer time for AU than AA (P = 0.006). Factors significantly influencing response to DCP, evaluated by multivariate analysis, were older age at onset (P = 0.02), disease duration before DCP initiation (P = 0.003), and treatment duration to initial hair regrowth (P = 0.001). The overall relapse rate was 63.9%, with a median of 39 weeks between response and relapse. The most common side effect was blistering (73.7%). Conclusion: DCP is effective and safe for treating extensive AA. Favorable prognostic factors are low disease severity, late disease onset, short duration before DCP treatment, and short duration to initial response. As the relapse rate is high, maintenance therapy should be considered.