Topical immunotherapy with diphenylcyclopropenone in the treatment of chronic extensive alopecia areata

Sotiriadis, Dimitrios; Patsatsi, Aikaterini; Lazaridou, Elisavet; Kastanis, A.; Vakirlis, Efstratios; Chrysomallis, Fotis

doi:10.1111/j.1365-2230.2006.02256.x

Cited by 30 publications

(32 citation statements)

References 11 publications

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“…Other similar immunomodulatory therapies include the use of the topical medication DPCP, which is currently approved for the treatment of alopecia areata and recalcitrant warts [104, 105]. DPCP is thought to act as a hapten or local irritant, which can induce a potent contact sensitization response, triggering the activation of epidermal LCs.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Understanding Dendritic Cells and Their Role in Cutaneous Carcinoma and Cancer Immunotherapy

Yanofsky

Mitsui

Felsen

et al. 2013

Clinical and Developmental Immunology

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Dendritic cells (DC) represent a diverse group of professional antigen-presenting cells that serve to link the innate and adaptive immune systems. Their capacity to initiate a robust and antigen-specific immune response has made them the ideal candidates for cancer immunotherapies. To date, the clinical impact of DC immunotherapy has been limited, which may, in part, be explained by the complex nature of DC biology. Multiple distinct subsets of DCs have been identified in the skin, where they can be broadly subcategorized into epidermal Langerhans cells (LC), myeloid-derived dermal dendritic cells (mDC) and plasmacytoid dendritic cells (pDC). Each subset is functionally unique and may activate alternate branches of the immune system. This may be relevant for the treatment of squamous cell carcinoma, where we have shown that the tumor microenvironment may preferentially suppress the activity of mDCs, while LCs remain potent stimulators of immunity. Here, we provide an in depth analysis of DC biology, with a particular focus on skin DCs and their role in cutaneous carcinoma. We further explore the current approaches to DC immunotherapy and provide evidence for the targeting of LCs as a promising new strategy in the treatment of skin cancer.

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Section: Therapeutic Implicationsmentioning

confidence: 99%

Understanding Dendritic Cells and Their Role in Cutaneous Carcinoma and Cancer Immunotherapy

Yanofsky

Mitsui

Felsen

et al. 2013

Clinical and Developmental Immunology

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“…Other side effects may include lymph-node enlargement, headache, itching, and pigmentary disorders. 4 After conducting a full medical literature search, we found no reports of diphenylcyclopropenone causing scalp angioedema. With no proven long-term, yet efficacious, therapy for the treatment of alopecia areata, we found it relevant to highlight a risk of using diphenylcyclopropenone, most specifically at high doses.…”

mentioning

confidence: 99%

“…The exact mechanism of action is unknown, but it has been theorized to increase clearance of follicular antigens through recruitment of new T cells, antigenic competition, and excessive production of proinflammatory cytokines by the follicular keratinocytes. 4 Recommended treatment with diphenylcyclopropenone includes sensitizing a patient with a higher dose of the medication, such as 2%, followed by lower concentrations of the medication applied once weekly. Only observational studies have been conducted to show the efficacy of diphenylcyclopropenone using this recommended treatment regimen.…”

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confidence: 99%

Extensive Scalp Angioedema following High-Dose Diphenylcyclopropenone for Alopecia Areata

2014

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Objective: To describe a case of an unusual adverse drug reaction to diphenylcyclopropenone for the treatment of alopecia areata. Case summary: A 31-year-old Caucasian male presented with extensive angioedema to the head with neck involvement 10 days following treatment with diphenylcyclopropenone 2% solution in acetone topically on his scalp to treat alopecia areata. Findings on patient presentation included edema of the soft tissues (deeper dermis and subcutaneous tissue) of the head and face with mild neck involvement, acute inflammatory changes from chemical-induced irritation, scalp erythema, and serous fluid drainage from inflamed and fissured edematous scalp. Acute treatments used for control of the reaction included intravenous steroids and antihistamines during hospitalization followed by oral steroids and antihistamines for maintenance during outpatient treatment of the resolving condition. Discussion: The role of topical diphenylcyclopropenone in this case of alopecia areata is probable according to the Naranjo criteria, with a score of 8. Diphenylcyclopropenone is not approved by the US Food and Drug Administration, but it has been used by many clinicians for the treatment of alopecia areata. Diphenylcyclopropenone causes an allergic contact dermatitis in the area of hair loss. In general, diphenylcyclopropenone is applied at a high concentration of 2% once and then at lower concentrations once weekly after the sensitization dose. This patient applied the 2% concentration on multiple consecutive days. Conclusion: Frequent use of topical diphenylcyclopropenone 2% applied to the scalp may cause scalp angioedema.

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“…[12] In a study with a long follow-up period (mean 30.8 months) long-term maintenance of full regrowth, while on continuing treatment, was demonstrated by 38% of the responders and by 19% after goingoff all treatment. [13]…”

Section: Efficacy Resultsmentioning

confidence: 99%

Topical immunotherapy in alopecia areata

Singh

Lavanya

2010

Int J Trichol

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Alopecia Areata (AA) is a common non-scarring alopecia directed against the anagenic hair follicle. Various treatment modalities have been used for the treatment of severe AA. Topical immunotherapy is the best documented treatment so far for severe and refractory AA. Dinitrochlorobenzene (DNCB), squaric acid dibutylester (SADBE), and diphencyprone (DPCP) are the contact allergens used for this purpose. DNCB has been found to be mutagenic by the Ames test and is largely replaced by DPCP and SADBE. DPCP and SADBE are both known to be non-mutagenic compounds and have comparable efficacy results and relapse rates. SADBE requires special solvents and additives to maintain its potency and is more expensive than the rest. DPCP has a response rate varying from 60% in severe Alopecia Areata to 17% in patients with alopecia totalis or universalis, and shows about 88 to 100% high response rate in patients with patchy Alopecia Areata.

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Topical immunotherapy with diphenylcyclopropenone in the treatment of chronic extensive alopecia areata

Cited by 30 publications

References 11 publications

Understanding Dendritic Cells and Their Role in Cutaneous Carcinoma and Cancer Immunotherapy

Understanding Dendritic Cells and Their Role in Cutaneous Carcinoma and Cancer Immunotherapy

Extensive Scalp Angioedema following High-Dose Diphenylcyclopropenone for Alopecia Areata

Topical immunotherapy in alopecia areata

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