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Five‐year experience in the treatment of alopecia areata with DPC
Author(s) -
ElZawahry BM,
Bassiouny DA,
Khella A,
Zaki NS
Publication year - 2010
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2009.03401.x
Subject(s) - medicine , scalp , alopecia areata , alopecia universalis , hair loss , dermatology , surgery , gastroenterology
Background The effectiveness of Diphencyprone (DPC) in alopecia areata (AA) was demonstrated in several studies with highly variable response rates ranging from 5% to 85%. Objective The response rate and variable factors affecting the prognosis were studied focusing on long‐term follow‐up with or without maintenance therapy. Methods A total of 135 cases of AA were treated with DPC. Patients were divided into five groups according to the area of scalp affected: Grade 1 AA: 25–49% scalp affection; Grade 2 AA: 50–74% scalp affection; Grade 3 AA: 75–99% scalp affection; alopecia totalis and alopecia universalis. An initial response was defined as appearance of new terminal hair within treated sites. Excellent response was defined as terminal hair covering >75% of the scalp. Relapse meant >25% hair loss. Maintenance therapy meant ongoing therapy once every 1–4 weeks after excellent response. Follow‐up was performed to detect any relapse of AA. Results Ninety‐seven patients continued therapy for ≥3 months. After an initial 3 month lag, cumulative excellent response was seen in 15 patients (15.4%), 47 patients (48.5%), 51 patients (52.6%) and 55 patients (55.7%) after 6, 12, 18 and 24 months respectively in a mean median time of 12 months. The only patient variable affecting the prognosis was baseline extent of AA. Excellent response was seen in 100%, 77%, 54%, 50% and 41% in Grade 1, Grade 2, Grade 3, AA totalis and AA universalis patients respectively. Side‐effects were few and tolerable. Hair fall >25% occurred in 17.9% of patients on maintenance and 57.1% of patients without maintenance therapy ( P ‐value = 0.025). Conclusion Diphencyprone is an effective and safe treatment of extensive AA. A long period of therapy is needed and will increase the percentage of responders especially in alopecia totalis and universalis. Maintenance therapy is recommended to reduce the risk of relapse.