Diphenylcyclopropenone Treatment Outcomes for Alopecia Areata

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 and 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.