Topical Immunotherapy in Alopecia Areata

    Gurcharan Singh, • Lavanya
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    TLDR Topical immunotherapy, especially with DPCP, is effective for treating severe alopecia areata.
    Alopecia Areata (AA) is a common non-scarring hair loss condition, and topical immunotherapy has been the most documented treatment for severe and refractory cases. The contact allergens used include Dinitrochlorobenzene (DNCB), squaric acid dibutylester (SADBE), and diphencyprone (DPCP). DNCB was found to be mutagenic and has been largely replaced by DPCP and SADBE, which are non-mutagenic and have similar efficacy and relapse rates. SADBE is more expensive due to the need for special solvents and additives. DPCP showed a response rate of 60% in severe AA, 17% in alopecia totalis or universalis, and 88-100% in patchy AA.
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