119 Prognostic Factors In The Treatment Outcome Of Severe Alopecia Areata With Topical Diphenylcyclopropenone

A. Sivayathorn, S. Suwanwalaikorn, S. Thongserm, B. Tangtong. Department of Dermatology, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Topical immunotherapy with diphenylcyclopropenone (DPCP) is an effective treatment for extensive forms of alopecia areata (AA). However it requires prolonged period of treatment and causes potential uncomfortable side effects. Previous studies of prognostic factors for the outcome of this treatment have been reported with variable results. The purpose of this study is to identify prognostic factors, which facilitate selection of patients for topical DPCP treatment. Retrospective analysis of data of 41 patients (32 females, 9 males) with severe AA treated with topical DPCP for at our hair clinic was performed. There were 19 patients with severe multiple patchy AA (MAA; 30-90% hair loss), 2 alopecia totalis (AT), 18 alopecia universalis (AU) and 2 diffuse type of AA. Ten factors were evaluated as potential prognostic factors. These include type of AA at the initial time of treatment, sex, age at onset, age at the initial treatment with DPCP, duration of the disease before treatment, history of recurrence, loss of body hair and eye brow, presence of nail changes, personal and family history of autoimmune diseases. Statistic analysis was performed by Chi-square tests. Twenty-four (58.53%) of forty-one patients exhibited a good response (>90%hair growth). Factors that appeared to be significantly prognostic for treatment outcomes are: type of AA at the initial time of treatment (MAA; response rate 19/19), AU and diffuse AA (response rate 4/16; p= 0.001), loss of body hair or eyebrow (response rate 8/20 vs 12/20 for those without; p=0.019) and age at onset (28.8±14.9 yrs. in response group vs 20.2±9.9 yrs. in non-response group; p= 0.045). MAA and older age of onset appeared to favor prognostic outcomes whereas AU and diffuse AA, loss of body hair or eyebrow and younger age of onset appeared to associate with unfavorable prognostic outcomes. Such prognostic factors are useful in screening and informing candidates for DPCP immunotherapy.