High Pre-treatment Serum IgE level may Predict Over-reactivity to DPCP treatment

  • Prof/Dr Xingqi Zhang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Ying Zhao, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Zeming Cai, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Sillani Caulloo, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Bin Zhang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Xuhua Tang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Jian Yang, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China
  • Dr Wenna Chen, Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, China

Objective: We aimed to investigate factors related to the side-effects including over-reactivity in alopecia areata (AA) patients on DPCP treatment.
Methods: Twenty one patients visiting our hair clinic were enrolled in this study. The patient group consisted of 12 males and 9 females, aged 11-40 years, with a mean of 22 years. The average duration of AA was 7.1years with a range of 3 months to 18 years. Areas of hair loss were from 20% to100%, with an average of 86%. Clinical, laboratory and pathological features in individual patients were investigated.
Results: Out of the 21 patients, 8 (side-effect group) gave up treatment before sufficient time was allowed to judge the effectiveness of treatment, due to side effects such as severe local and systemic contact dermatitis and vitiligo. From remaining 13 patients, 7 achieved satisfactory hair regrowth (responder group), making the response rate 54% (7/13). No obvious hair regrowth was observed in 6 patients (non-responder group). No statistical significance was found on comparison of patients’ age, area of hair loss and duration of AA among these three groups. Interestingly, 6 patients from the side-effect group (6/8, 75%) had elevated serum IgE levels before treatment. None of patients from the responder group and only one patient from the non-responder group (1/6, 16.7%) was found with elevated serum IgE level (P<0.05). Histopathologically, cell counts of biopsied AA scalp tissue before DPCP treatment revealed that in perivascular areas of mid-dermis, less mononuclear cells were found in both non-responder and side-effect group (P<0.05).
Conclusion: In this study involving DPCP treatment, we had a response rate similar to other studies. Over-reactivity to DPCP seems to be associated with pre-existing hypersensitivity , but not with patient’s age or severity of AA. It may be used as a predictor to avoid further unwanted complications during DPCP treatment.