title: Efficacy and safety of diphenylcyclopropenone alone or in combination with anthralin in the treatment of chronic extensive alopecia areata: a retrospective case series.
abstract: 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.
  
  
  CONCLUSIONS
  The retrospective design and small number of patients are limitations.
  
  
  CONCLUSIONS
  Combination therapy with DPCP and anthralin is superior to DPCP alone in chronic extensive AA.
authors: Department of Dermatology, Başkent University Faculty of Medicine, Adana Hospital, Turkey. Electronic address: sivandr@hotmail.com.
authors: Murat
authors: M
authors: Durdu
authors: Department of Dermatology, Başkent University Faculty of Medicine, Ankara Hospital, Turkey.
authors: Deren
authors: D
authors: Özcan
authors: Department of Dermatology, Başkent University Faculty of Medicine, Adana Hospital, Turkey.
authors: Mete
authors: M
authors: Baba
authors: Department of Dermatology, Başkent University Faculty of Medicine, Ankara Hospital, Turkey.
authors: Deniz
authors: D
authors: Seçkin
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000506:Alopecia Areata / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000875:Anthralin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D016516:CD4-CD8 Ratio; D002648:Child; D003521:Cyclopropanes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism; D003875:Drug Eruptions / Q000209:etiology; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005499:Folliculitis / Q000139:chemically induced; D005500:Follow-Up Studies; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000139:chemically induced; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003521:Cyclopropanes; D016207:Cytokines; C029402:diphenylcyclopropenone; D000875:Anthralin
keywords: adverse effects; alopecia areata; alopecia totalis; alopecia universalis; anthralin; cignolin; diphencyprone; diphenylcyclopropenone; dithranol; folliculitis