Vitiliginous Lesions During Contact Immunotherapy for Alopecia in a Patient with Autoimmune Thyroiditis

July 2014 in “ Our Dermatology Online ”

Yasunobu Kato, Toshiyuki Yamamoto

alopecia autoimmune thyroiditis vitiliginous lesions topical squaric acid dibutylester SADBE hair regrowth depigmentation autoimmune response contact leucoderma anti-thyroid antibodies melanocytes CD8-positive T-cell infiltration topical corticosteroids contact immunotherapy vitiligo

Studysummary This case report documents the development of vitiligo-like lesions in a patient with autoimmune thyroiditis following the use of topical squaric acid dibutylester for alopecia. Our plain-language summary of this paper — not a Tressless recommendation.

A 60-year-old female with autoimmune thyroiditis developed vitiliginous lesions after two months of topical squaric acid dibutylester (SADBE) treatment for alopecia. Despite initial hair regrowth, depigmentation spread beyond the application areas, suggesting an autoimmune response rather than contact leucoderma. Laboratory tests showed normal liver and renal function but elevated anti-thyroid antibodies. A skin biopsy revealed decreased melanocytes and CD8-positive T-cell infiltration. SADBE therapy was discontinued, and topical corticosteroids led to significant improvement within nine months. The case highlighted the need for caution when using contact immunotherapy in patients with autoimmune conditions.

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Research cited in this study

3 / 3 results

research Vitiligo After Diphencyprone for Alopecia Areata

18 citations , January 2010 in “Dermatology Research and Practice”

This case report describes a 30-year-old Brazilian male who developed vitiligo lesions following diphencyprone therapy for alopecia areata.

research Topical Immunotherapy in Dermatology

22 citations , March 1999 in “International Journal of Clinical Practice”

This review discusses the use of topical immunotherapy for severe alopecia areata and resistant viral warts, highlighting diphencyprone's advantages and the need for careful handling to avoid staff sensitisation; it reports no new clinical results.

research Vitiligo as a Reaction to Topical Treatment with Diphencyprone

55 citations , January 1988 in “Dermatology”

This study observed that 6.7% of patients treated with diphencyprone for alopecia areata developed vitiligo, with varying patterns and improvements noted among cases.