二苯环丙烯酮局部治疗斑秃的疗效分析

Therapeutic Effects of Topical Immunotherapy with Diphenylcyclopropenone on Alopecia Areata Patients

目的:分析斑秃患者局部外用二苯环丙烯酮(DPCP)疗效的影响因素。方法:对36例斑秃患者进行外用DPCP治疗,详细记录其临床资料及副作用;并对患者进行血清学检查、组织病理活检。结果:斑秃患者DPCP治疗总有效率为56.5%,复发率为23.1%。16.7%患者出现较明显副作用(严重接触性皮炎、白癜风)。副作用组患者在治疗前的血清IgE浓度明显高于有效组患者(P=0.03)。另外,患者年龄、发病年龄、病程、脱发面积、维持治疗浓度、自身免疫性疾病病史、异位性疾病病史和斑秃家族史、皮损病理改变与DPCP治疗的疗效无明显相关性。结论:外用DPCP治疗斑秃安全性较高,可避免长期使用皮质类固醇激素和免疫抑制剂的毒副作用,治愈率也较高。治疗前进行血清IgE测定可提前发现对治疗不耐受患者。

Objective：To analyze factors which influence the therapeutic effect of Diphenylcyclopropenone（DPCP） topical immunotherapy in alopecia areata（AA） patients. Methods：Detailed clinical data and adverse effects observed in 36 patients enrolled in this study were recorded.Laboratory blood tests as well as scalp tissue biopsy were carried out before DPCP treatment.Results：The responding rate was 56.5% in the study group.However a relapse rate of 23.1% was observed.16.7% of the subjects experienced relatively severe side-effects comprising of severe contact dermatitis and vitiligo.Pre-treatment serum IgE level was significantly higher in adverse-effects group than in responders group.Moreover,patients＇ age,age of onset,duration of disease,hair loss area,DPCP concentration for maintenance therapy,history of autoimmune/atopic diseases,family history of AA and lesional scalp tissue histopathological changes did not have significant correlation with outcome of DPCP treatment.Conclusion：Topical DPCP treatment of AA patients,besides being an effective method,is also relatively safer than other conventional forms of therapy including corticosteroids and immunosuppressants in regard to their systemic adverse effects and toxicity.Pre-treatment serum IgE level can be used as a prognostic marker of DPCP intolerance.