Diphenylcyclopropenone (diphencyprone, DPCP) in the treatment of chronic severe alopecia areata (AA)

Background: Diphenylcyclopropenone (DPCP) has been reported to be an effective topical immunotherapy of extensive alopecia areata (AA) with highly variable reported results. Objective: The purposes of this study were to assess the efficacy, side effects, and adverse prognostic factors in the treatment of alopecia areata with DPCP. Methods: 21 patients were included in the study with chronic and extensive AA. Patients were sensitized in the beginning with 2% DPCP, and the concentrations were increased gradually beginning with 0.000001% every one to two weeks for a period of 6 months. Results: 15 patients (71.4%) had a complete or partial recovery at the end of the treatment period. Most frequent side effects were erythema at the site of application, pigmentation, and lymph node enlargement. The most important adverse prognostic factors were duration of AA, history of atopy, and presence of nail changes. Conclusion: Treatment of AA with topical DPCP is effective. Though the treatment may have some side effects, in most cases they are tolerable and respond well to treatment.