title: Five-year experience in the treatment of alopecia areata with DPC.
abstract: BACKGROUND
  The effectiveness of Diphencyprone (DPC) in alopecia areata (AA) was demonstrated in several studies with highly variable response rates ranging from 5% to 85%.
  
  
  OBJECTIVE
  The response rate and variable factors affecting the prognosis were studied focusing on long-term follow-up with or without maintenance therapy.
  
  
  METHODS
  A total of 135 cases of AA were treated with DPC. Patients were divided into five groups according to the area of scalp affected: Grade 1 AA: 25-49% scalp affection; Grade 2 AA: 50-74% scalp affection; Grade 3 AA: 75-99% scalp affection; alopecia totalis and alopecia universalis. An initial response was defined as appearance of new terminal hair within treated sites. Excellent response was defined as terminal hair covering >75% of the scalp. Relapse meant >25% hair loss. Maintenance therapy meant ongoing therapy once every 1-4 weeks after excellent response. Follow-up was performed to detect any relapse of AA.
  
  
  RESULTS
  Ninety-seven patients continued therapy for >or=3 months. After an initial 3 month lag, cumulative excellent response was seen in 15 patients (15.4%), 47 patients (48.5%), 51 patients (52.6%) and 55 patients (55.7%) after 6, 12, 18 and 24 months respectively in a mean median time of 12 months. The only patient variable affecting the prognosis was baseline extent of AA. Excellent response was seen in 100%, 77%, 54%, 50% and 41% in Grade 1, Grade 2, Grade 3, AA totalis and AA universalis patients respectively. Side-effects were few and tolerable. Hair fall >25% occurred in 17.9% of patients on maintenance and 57.1% of patients without maintenance therapy (P-value=0.025).
  
  
  CONCLUSIONS
  Diphencyprone is an effective and safe treatment of extensive AA. A long period of therapy is needed and will increase the percentage of responders especially in alopecia totalis and universalis. Maintenance therapy is recommended to reduce the risk of relapse.
authors.affiliation: The Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: B M
authors.initials: BM
authors.lastname: El-Zawahry
authors.forename: D A
authors.initials: DA
authors.lastname: Bassiouny
authors.forename: A
authors.initials: A
authors.lastname: Khella
authors.forename: N S
authors.initials: NS
authors.lastname: Zaki
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000506:Alopecia Areata / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007223:Infant; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011208:Powders; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003521:Cyclopropanes; D011208:Powders; C029402:diphenylcyclopropenone