Immunological treatment of alopecia areata including the use of diphencyprone

Abstract

Immunomodulation is a characteristic shared by all modes of treatment which have a beneficial effect on hair regrowth in alopecia areata (AA). In AA with moderate hair loss, the chances of spontaneous remission are favourable and an expectative policy is indicated. Only in severe cases of AA is treatment justified. Topical immunotherapy with diphencyprone (or alternatively squaric acid dibutylester) is the treatment of choice, combining the highest rate of effectiveness with acceptable adverse effects. Despite considerable drawbacks, PUVA therapy can be considered as an alternative. Systemic administration of corticosteroids or cyclosporin A produces unacceptable side-effects and their topical application is ineffective. Intradermal injections of corticosteroids, however, can be very successful in AA of the eyebrows. me therapeutic effect of inosiplex and dapsone lacks confirmation in appropriately controlled studies.