Efficacy of topical diphenylcyclopropenone maintenance treatment for patients with alopecia areata: A retrospective study Sung Jay Choe, MD, Solam Lee,

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Efficacy of topical diphenylcyclopropenone maintenance treatment for patients with alopecia areata: A retrospective study Sung Jay Choe, MD, Solam Lee, MD, Hanil Lee, MD, Jaewoong Choi, MD, Won-Soo Lee, MD, PhD Journal of the American Academy of Dermatology Volume 78, Issue 1, Pages 205-207.e1 (January 2018) DOI: 10.1016/j.jaad.2017.07.028 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Scheme of diphenylcyclopropenone (DPCP) contact immunotherapy for alopecia areata (AA) patients. Patients with moderate-to-severe AA were treated with DPCP contact immunotherapy. DPCP treatment concentration was determined according to treatment response and clinical course, and all patients were treated with 0.01% to 0.1% DPCP. After sensitization, patients visited the hospital once a week, and the treatment interval was adjusted to once every 2 weeks or once every 3 weeks, depending on treatment response and compliance. Clinical improvement was defined as a >90% improvement of hair loss. If these improvements lasted >6 weeks, subsequent treatment was defined as DPCP-MT. After switching to DPCP-MT, the patient continued treatment at the same concentration. In the early stage of DPCP-MT, the treatment interval was maintained. The treatment interval was gradually lengthened depending on the stability of the response and patient compliance. All patients were treated at the hospital until clinical improvement was achieved. After switching to DPCP-MT, 18 patients who maintained a complete response for >3 months were trained in appropriate home DPCP application and handling methods by a dermatologist. DPCP, Diphenylcyclopropenone. Journal of the American Academy of Dermatology 2018 78, 205-207.e1DOI: (10.1016/j.jaad.2017.07.028) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Factors related to maintenance treatment interval that affected relapse. Of the patients on diphenylcyclopropenone (DPCP) maintenance treatment (MT), we first compared the treatment interval of patients who a had relapse with those who did not. Because there was a significant difference in Intervalmnt itself (P = .022), we focused on the change in treatment interval before and after transition to DPCP-MT. The ratio of average treatment interval before and after transition to DPCP-MT, and the time until adjustment of DPCP-MT Intervalmnt were also significantly different between the relapse and nonrelapse groups (P = .021, P < .01, respectively). Journal of the American Academy of Dermatology 2018 78, 205-207.e1DOI: (10.1016/j.jaad.2017.07.028) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions