■总体斑秃(AT)和普遍斑秃(AU)是斑秃(AA)的形式,由于自发性再生<10%,因此代表预后不良的最强预测指标。局部免疫治疗剂,在严重形式的AA中,二苯基环丙烯酮(DPCP)已显示出临床疗效,副作用有限。然而,其在以头皮完全脱发为特征的AT/AU中的特定作用可以帮助突出药物的功效,且混杂因素较少.
■数据收集自18例诊断为AT/AU并按照Happle等人的方案用DPCP局部免疫治疗的患者。记录脱发工具(SALT)评分和亚类的基线严重程度。在AU的情况下,还记录了基线体毛脱落评分。在治疗6个月后重新评估患者的SALT评分变化,并使用全局评估评分评估毛发再生。还评估并记录治疗期间的副作用。
■18例患者,其中11例(61.1%)被诊断为AU,7例(38.9%)被诊断为AT。平均年龄为21.6,男女比例为3:2。注意到的合并症为6例(33.3%),特应性和甲状腺功能减退症(5.5%),唐氏综合症中的两个(11.1%),1例(5.5%)患者仅有甲状腺功能减退。就诊时的平均病程为3年,所有患者对其他各种治疗方式仍然难以治疗。所有患者的基线SALT评分为100,对应于S5。经过6个月的治疗,27.7%的患者没有出现任何反应(SALT评分S5),16.6%的评分为S4,11.1%的评分为S3,11.1%的评分为S2,22.2%的评分为S1,11.1%的评分为S0。在评估体毛脱落评分的改善时,36.3%的患者没有好转,36.3%显示部分改善,27.2%的患者表现出完全的体毛再生。大约55.5%的患者出现明显的副作用,包括严重的局部反应。颈淋巴结病,痤疮和色素沉着在应用的部位以及未经处理的部位。
■AA的AT/AU亚型,适合使用接触性免疫治疗剂DPCP治疗,其中33.3%的患者毛发再生>75%。在63.6%的AU患者中出现了castling现象。注意到的不良反应不足以阻止治疗。
UNASSIGNED: Alopecia totalis (AT) and Alopecia universalis (AU) are forms of Alopecia areata (AA) which represent the strongest predictor of poor prognosis since spontaneous regrowth is <10%. Topical immunotherapy agent,
diphenylcyclopropenone (DPCP) has shown clinical efficacy with limited side effects in severe forms of AA. However, its specific role in AT/AU characterized by complete hair loss over the scalp can help highlight the efficacy of the drug with fewer confounders.
UNASSIGNED: Data were collected from 18 patients diagnosed with AT/AU and treated with topical immunotherapy with DPCP as per protocol by Happle et al. Baseline Severity of Alopecia Tool (SALT) score and subclass was recorded. In the case of AU, baseline body hair loss score was also recorded. Patients were reassessed after 6 months of treatment in terms of change in SALT score and hair regrowth was assessed using the Global Assessment Score. The side effects during treatment were also assessed and recorded.
UNASSIGNED: Eighteen patients of whom eleven (61.1%) were diagnosed as AU and seven (38.9%) as AT were treated. The mean age was 21.6, with a male: female ratio of 3:2. The comorbidities noted were atopy in six (33.3%), atopy and hypothyroidism in one (5.5%), Down\'s syndrome in two (11.1%), and hypothyroidism alone in one (5.5%) patient. The mean duration of disease at the time of presentation was 3 years and all patients had remained refractory to various other modalities of treatment. All patients had a baseline SALT score of 100 corresponding to S5. After 6 months of treatment, 27.7% of patients did not show any response (SALT score S5), 16.6% had a score of S4, 11.1% had a score of S3, 11.1% had a score of S2, 22.2% had a score of S1, and 11.1% had a score of S0. On assessing improvement in body hair loss score, 36.3% of patients showed no improvement, 36.3% showed partial improvement, and 27.2% of patients showed complete body hair regrowth. About 55.5% of patients developed notable side effects that included severe local reactions, cervical lymphadenopathy, acne and pigmentation at the site of application as well as untreated sites.
UNASSIGNED: The AT/AU subtypes of AA, was amenable to treatment with contact immunotherapeutic agent DPCP with a >75% hair regrowth in 33.3% of patients. The castling phenomenon was seen in 63.6% of AU patients. The adverse effects noted were not severe enough to deter treatment.