Application of Topical Immunotherapy in the Treatment of Alopecia Areata: A Review and Update

Drug Des Devel Ther. 2021 Mar 23:15:1285-1298. doi: 10.2147/DDDT.S297858. eCollection 2021.

Abstract

Treatment of extensive or recalcitrant alopecia areata (AA) is a major clinical challenge. Even after thorough investigation of several medications, its treatment outcomes have remained unsatisfactory. While there is no US Food and Drug Administration-approved medication for AA yet, topical immunotherapy has been a well-documented treatment option. Dinitrochlorobenzene, squaric acid dibutylester, and diphenylcyclopropenone are three substances that have demonstrated efficacy in the treatment of extensive or recalcitrant AA. Despite being commonly used, the mechanism underlying topical immunotherapy is not well-elucidated and a wide range of clinical efficacies have been reported in the literature. The aim of this review was to summarize and update the pharmacology, mechanism of action, therapeutic efficacy, and tolerability of topical immunotherapy in the treatment of AA.

Keywords: contact sensitizers; dinitrochlorobenzene; diphencyprone; diphenylcyclopropenone; hair loss; squaric acid dibutylester.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / therapeutic use*
  • Administration, Topical
  • Alopecia Areata / therapy*
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / therapeutic use*
  • Immunotherapy*

Substances

  • Adjuvants, Immunologic
  • Immunologic Factors