Background: Some patients with chronic extensive alopecia areata (AA) may be refractory to topical immunotherapy. Combination therapy is recommended for such patients. Efficacy and safety of a combination therapy with diphenylcyclopropenone (DPCP) and anthralin in chronic extensive AA is unknown.
Objective: We sought to determine whether the combination therapy of DPCP and anthralin is superior to DPCP alone in chronic extensive AA.
Methods: We retrospectively analyzed the efficacy, side effects, and relapse rates of DPCP (alone or with anthralin) in chronic extensive AA.
Results: A total of 47 patients (22 were treated only with DPCP, and 25 with DPCP and anthralin for at least 30 weeks) were evaluated. Complete hair regrowth was observed in 36.4% and 72% of the patients who received DPCP and combination therapy, respectively (P = .01). Hair regrowth duration was shorter with combination therapy (P = .01). Regrowth rates of the eyebrows, eyelashes, and beard in patients on combination therapy were higher than those in patients on DPCP (P = .01). Side effects such as folliculitis, hyperpigmentation, and staining of skin, hair, and clothes were more common in combination therapy group.
Limitations: The retrospective design and small number of patients are limitations.
Conclusion: Combination therapy with DPCP and anthralin is superior to DPCP alone in chronic extensive AA.
Keywords: adverse effects; alopecia areata; alopecia totalis; alopecia universalis; anthralin; cignolin; diphencyprone; diphenylcyclopropenone; dithranol; folliculitis.
Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.