Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients.
Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients.
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DOI：
10.1038/jidsymp.2015.28
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发表时间：
2015-11-01
期刊：
影响因子：
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通讯作者：
Bergfeld, Wilma F
中科院分区：
文献类型：
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作者：
Chiang, Katherine S;Mesinkovska, Natasha A;Bergfeld, Wilma F
二苯基环丙烯酮 (DPCP) 被广泛认为是治疗难治性或广泛性斑秃 (AA) 最有效的局部免疫疗法，但有关在终止前尝试 DPCP 治疗多长时间以及哪些因素可预测治疗成功的问题仍未得到解答。在这项针对 50 名 AA 患者的回顾性研究中，我们评估了 DPCP 疗效并确定了预测治疗成功/失败的患者因素。 DPCP 治疗的中位持续时间为 3 年，47% 的患者在 DPCP 治疗的前 6 个月内首次出现再生，20% 的患者在 6 个月至 1 年内出现首次再生，8% 的患者在 1-2 年内出现首次再生。在我们的研究中，71% 的全秃患者和 56% 的普秃患者达到了治疗成功（定义为 50% 终毛再生）。三个因素是治疗效果不佳的统计显着预测因素——DPCP 治疗前脱发程度、甲状腺疾病史和体毛受累程度。 44% 的患者出现复发，且与甲状腺疾病史显着相关。常见的副作用是瘙痒、皮疹和局部淋巴结肿大。这项研究的结果支持了我们的信念，即 DPCP 治疗是一种可行的治疗选择，可以在家中成功完成，并且不应在 2 年前终止。
Diphenylcyclopropenone (DPCP) is widely considered the most effective topical immunotherapy for refractory or extensive alopecia areata (AA), but questions regarding how long to try DPCP therapy before terminating and what factors are prognostic of therapeutic success still remain unanswered. In this retrospective study of 50 AA patients, we evaluated DPCP efficacy and identified patient factors predictive of therapeutic success/failure. The median duration of DPCP treatment was 3 years, with 47% patients experiencing their first regrowth in the first 6 months of DPCP therapy, 20% between 6 months-1 year, and 8% between 1-2 years. In our study, treatment success, defined as ⩾50% terminal hair regrowth, was reached in 71% of alopecia totalis patients and in 56% of alopecia universalis patients. Three factors were statistically significant predictors of poor treatment outcome-extent of hair loss before DPCP treatment, history of thyroid disease, and extent of body hair involvement. Relapse was observed in 44% of patients and significantly associated with history of thyroid disease. Common side effects were itching, rash, and local lymphadenopathy. The results of this study support our belief that DPCP therapy is a viable treatment option, can be successfully accomplished at home, and should not be terminated before 2 years.