Topical immunotherapy with diphenylcyclopropenone in vitiligo: A preliminary experience
Despite recent significant therapeutic advances, vitiligo remains a clinical conundrum. Topical immunotherapy has been extensively tested in the treatment of various dermatologic disorders, especially those believed to have an immunologic basis.
To evaluate the role of topical diphenylcyclopropenone (DPCP) in the treatment of vitiligo.
Nineteen patients with limited vitiligo lesions were enrolled in this study. After sensitization with 2% lotion of DPCP in acetone, progressively higher concentrations beginning at 0.001% up to 2% were applied weekly for 6 months to the depigmented skin lesions.
Thirteen of the 19 patients were evaluated at the end of 6 months. Four patients with focal vitiligo, one patient with vitiligo vulgaris, and three patients with segmental vitiligo showed marked (grade 3) repigmentation.
Marginal and central repigmentation with hyperpigmented borders was seen in the majority of lesions. Further controlled trials should be undertaken to evaluate the use of topical DPCP in vitiligo.
Available from: Oriana Simonetti
Available from: ncbi.nlm.nih.gov
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ABSTRACT: Diphencyprone is a universal contact immunotherapy. The mechanism of action is based on an induction of the delayed-type hypersensitivity. Diphencyprone has been used in various forms for treatments of recalcitrant and facial warts, and alopecia areata. However, this treatment modality has not been generally used in immunocompromised patients.
The present report demonstrated the efficacy of diphencyprone immunotherapy on the treatment of generalized molluscum contagiosum in a human immunodeficiency virus (HIV)-infected patient. Minimal and transient side effects including pruritus, postinflammatory hyperpigmentation and irritation were noted.
Diphencyprone contact immunotherapy appears to be a possible alternative treatment of widespread molluscum contagiosum in immunocompromised patients.
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ABSTRACT: Alopecia areata (AA) is an inflammatory skin disease the most effective therapy for which is diphenylcyclopropenone (DPCP). Videodermatoscopy and intra-vital capillaroscopy (IVCP) are two non-invasive techniques that help in the differential diagnosis of alopecias. It is known that, after DPCP therapy, there is a histologically proven significant increase of VEGF in hair follicle keratinocytes and a consequent increase in capillary vessels in the dermis of the same follicles. The aim of our study is to emphasize any clinical and videodermatoscopic-videocapillaroscopic changes after DPCP treatment in 20 patients affected by alopecia areata. Videodermatoscopic images and an intravital videocapillaroscopic analysis were performed at T0, T12 and T24 to emphasize clinical modifications and microscopic changes in vascular pattern before and after DPCP treatment. At T0, videodermatoscopy showed the presence of exclamation point hairs, hair follicles filled with hyperkeratotic plugs (yellow dots), hair follicles containing cadaverized hairs (black dots) and broken hairs. IVCP highlighted a pale scalp, and vessels were not visible. At 24 weeks (T24), videodermatoscopy revealed the disappearance or a statistically significant reduction of AA hallmarks and an increase of number of vellus hairs. Videocapillaroscopy showed a statistically significant increase of new vessels and, where neoangiogenesis were more marked, a major hair regrowth was evident. Our study emphasizes that, after DPCP therapy, neoangiogenesis is detectable by videocapillaroscopy and these new capillaries could be considered an initial positive attempt to compensate capillary loss of T0 alopecia areata images.
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