Effect of Fexofenadine as an Adjunct to DPCP in Non-Atopic Patients with Alopecia Areata: A Randomized Clinical Trial

Abstract

Introduction: In this study the effect of fexofenadine as an adjunct to diphenylcyclopropenone (DPCP) in nonatopic patients with Alopecia areata (AA) is investigated. Patients and methods:Prospectively 100 patients with AA having hair loss of more than 25% of the scalp are randomly divided into two groups in group A patients received topical DPCP plus oral fexofenafine, in group B patients received only topical DPCP. Results:Regrowth in group A was better than group B but this was not statistically significant. Eczematous reaction and pruritus was significantly lower in group A than in group B.Discussion: Fexofenadine seems to be of no benefit in patients without underlying contributing situation. Therefore, it can be added to conventional regimen in order to enhance the compliance of patients by reducing discomfort of DPCP treatment. Fexofenadine, an H1 receptor antagonist decreases the production of IFN-γ from T lymphocytes [13], as well as the expression of ICAM-1 on epithelial cells, supporting its efficacy for AA [14]. From these findings, antihistamines are expected to be effective for AA treatment. Indeed, the efficacy of antihistamines for AA has been reported [15][16][17][18][19]. Effect of Fexofenadine as anRecently, it has been reported that fexofenadine rapidly suppresses itch due to DPCP immunotherapy for AA, indicating that fexofenadine is an adequate concomitant drug [20]. Also it is found that fexofenadine is effective for AA of atopic background [19,21]. In this study which is a prospective randomized clinical trial we investigate the effect of fexofenadine as an adjunct to DPCP in non-atopic patients with AA. Patients and MethodsWe surveyed prospectively 100 patients with AA having hair loss of more than 25% of the scalp in Razi hospital from January 2009 to January 2011. We excluded patients with pregnancy, lactation, history of atopy, patients who had received systemic corticosteroid or any other medication within 3 months before starting point of evaluation or for AA; also we excluded patients with cardiovascular disease and blood dyscrasia; we randomly divided the patients into two groups (A and B), their age varied between 6 to 47 years. In group A there were 50 patients who received topical diphenylcyclopropenone (DPCP) plus oral fexofenafine, who took fexofenafine (120 mg/day for adults or 60 mg/day for children); in group B there were 50 patients who received only topical DPCP, in group A we lost 6 patients due to headache (1 patient), vitiligo (1 patient) and discontinue to follow up (4 patients), in group B we lost 4 patients, one patient due to severe eczematous reaction and 3 patients due to discontinue follow up (Figure 1).In group A there were 22 (44%) male and 28 (56%) female; in group B there were 26 (52%) male and 24 (48%) female the mean age was 25 ± 9.2 in group A and 24 ± 8.7 in group B. The severity of AA was evaluated using the Severity of Alopecia Tool (SALT) score proposed in the guidelines of the National Alopecia Areata Foundation [22,23]; S 0 : no hair loss; S...

Emerging Unconventional Therapies for Alopecia Areata

“…The enhancement of hair growth in those instances has been classically attributed to diphenylcyclopropenone. However, several authors have described that antihistamines can enhance hair regrowth on their own, including a case of a patient with ophiasis, who after failing prior therapies, responded to administration of fexofenadine 120 mg/d (Nonomura et al, 2012;Soltanahmadi and Akhyani, 2012). Fexofenadine is a histamine H1 receptor antagonist with a relatively safe profile and no marked sedation.…”