Pigmented Contact Dermatitis Due to Therapeutic Sensitizer as a Complication of Contact Immunotherapy in Alopecia Areata

    June 2010 in “ Journal of dermatology ”
    Shigeki Inui, Takeshi Nakajima, Naoyuki Toda, Satoshi Itami
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    TLDR Some patients with severe alopecia areata developed skin darkening from their treatment, which may indicate a less effective response to the therapy.
    In a study of 186 patients treated with contact immunotherapy (CI) using diphenylcyclopropenone for alopecia areata (AA), 11 patients (5.91%) developed hyperpigmentation, all of whom had severe forms of AA, either totalis (AAT) or universalis (AAU). The study aimed to understand the incidence and pathophysiology of this pigmentary complication. A comparison between the 11 AAT or AAU patients with hyperpigmentation and the 67 without showed that those with pigmentation had a poorer response to CI (P < 0.05), although no significant correlations were found with age, sex, atopic background, duration of CI, final concentration of diphenylcyclopropenone, or administration of antihistamines. Histopathological examination revealed that the pigmentation was consistent with pigmented contact dermatitis (PCD), caused by the therapeutic sensitizer, and it was suggested to be an indicator of poor responsiveness to CI treatment.
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