149 ALOPECIA AREATA AND UVEITIS

J. J. Stene, Fl. Neczyporenko, M. Song Department of Dermatology, CHU St. Pierre, ULB, Brussel, Belgium

We report the case of a 38-year-old-woman treated for 3 years by contact immunotherapy with diphencyprone (DCP) for severe alopecia areata (AA). In June 2000, alopecia was still evolutive in some areas: the concentration of DCP was increased from 2.3% to 2.5%; 30 hours after the application, the patient presented a papulovesicular eruption of the frontal region, headaches and a decrease of the visual acuity. Ophtlamic examination showed a bilateral uveitis, iris atrophy and discret lesions of the choroid. Investigations by PCR from aqueous humor were negative for HSV, HZV and CMV. Biological investigations showed normal thyroid function but presence of auto-antibodies. Complement was in normal range; there were no circulating immune complexes and no antinuclear antibodies. Viral serologies showed the absence of recent infection for HSV, HZV, CMV, EBV or hepatitis C. 30 mg of Prednisolone were given and uveitis progressively disappeared in 3 weeks. There were few possibilities that uveitis could be a direct consequence of the treatment: contact immunotherapy with DCP has been used for many years and such a side effect has never been reported. However, we could suggest that immunological process induced by DCP, revealed a genetic predisposition for uveitis. Effectively, AA and uveitis can be associated in the rare Vogt-Koyanagi-Harada syndrom which can, beyond ocular and dermatological manifestations, associate meningo-encephalitic and auditory involvement.