Treatment of Chronic Severe Alopecia Areata with Topical Diphenylcyclopropenone and 5% Minoxidil: A Clinical and Immunopathologic Evaluation

The study evaluated the effectiveness of topical diphenylcyclopropenone (DPCP) and 5% minoxidil in treating chronic severe alopecia areata. The success rate of DPCP was found to be 38%, while topical 5% minoxidil did not produce any additional benefit. Responders tended to maintain a lesser lymphocytic infiltrate and diminished ICAM-1 expression compared to non-responders during treatment. The study suggests that future therapy for chronic severe alopecia areata may involve the development of a specific cytokine or cytokine inhibitor that can maintain low ICAM-1, keep lymphocytic infiltrates low, and redirect the immune response away from the antigen responsible for alopecia areata.