Takeaway
- Combination therapy with diphenylcyclopropenone (DPCP) and anthralin (Drithocreme, Zithranol) is associated with worse efficacy and safety compared with DPCP alone in patients with chronic, extensive alopecia areata.
Why this matters
- DPCP and anthralin have previously shown efficacy, but their combination does not appear to improve outcomes.
Key results
- DPCP alone was associated with a higher rate of complete hair regrowth compared with combination therapy (62.5% vs 18.2%; P=.04).
- Response was negatively correlated with alopecia areata:
- Duration: P=.03 in patients treated with DPCP alone; P=.02 in patients treated with combination therapy.
- Severity: P=.008 in patients treated with DPCP alone; P=.02 in patients treated with combination therapy.
- Patients treated with combination therapy had higher rates of vesicular eruptions (92% vs 42%), folliculitis (75% vs 25%), and localized pruritus (83% vs 58%) compared with patients who received DPCP alone; rates were similar for regional lymphadenopathy (8% for both); and the rate of influenza-like symptoms was higher in patients who received DPCP alone (25% vs 8%).
Study design
- 24 patients with alopecia areata (12 treated with DPCP alone and 12 with DPCP/anthralin combined therapy for at least 24 weeks) were included.
- Funding: None.
Limitations
- Small patient sample size.
References
References