FC-10   THE EFFICACY OF EBASTINE, A SECOND-GENERATION ANTIHISTAMINE, IN THE TREATMENT OF ALOPECIA AREATA

Y. Yoshizawa, S. Kawana. Department of Dermatology, Nippon Medical School.Tokyo. Japan.

Background: Although its etiology is not entirely clear, the infiltration of inflammatory cells is increased around hair follicles in lesions of alopecia areata (AA), and the type of immune cells that are increased are mast cells. Such evidence suggests that mast cells play some role in the pathogenesis of AA. Objective: The aim of this study was to evaluate the efficacy of a second-generation antihistamine in the treatment of AA. Methods: Two studies were performed. In study I, 9 patients with moderate AA were treated with diazepam for 3 months and patients who did not respond to the diazepam therapy were then treated with ebastine, a second-generation antihistamine, instead of diazepam. In study II, 22 patients with moderate AA were initially treated with ebastine for at least 3 months. The efficacy of these medications was checked after 3 months of the therapy. If any benefit effects were noted at that time, the therapy was continued until 5 months and the final efficacy was evaluated. Results: In study I, of the 9 patients, only one (11%) showed an excellent response to diazepam. Of the remaining 8 patients, 5 (62%) showed an excellent response to the subsequent ebastine therapy. In study II, 13 out of the 22 patients (59%) showed an excellent response. Together, 18 out of 30 patients (60%) were excellent responders to ebastine therapy, excluding the patient who responded to diazepam. Ebastine therapy also showed a tendency to be more effective in patients with emotional stress than in those without stress. There were no statistical differences in eosinophil counts, in serum IgE levels, and in serum interleukin 4 levels between excellent or poor responders to ebastine. Serum IgE levels were, however, significantly decreased after ebastine therapy in the excellent responders, while the poor responders had no change in IgE levels. Conclusion: We propose that the administration of a second-generation antihistamine is an efficient therapy for moderate AA however, the results obtained here should be interpreted with caution, as is the case for most open studies.