Topical immunotherapy with diphenylcyclopropenone-induced vitiligo

Use of Contact Immunotherapy in the Treatment of Skin Diseases Other than Alopecia Areata

For decades, contact immunotherapy with dinitrochlorobenzene, diphencyprone, and squaric acid dibutylester has played an important role in both clinical practice and scientific research. It is listed as the first-line treatment for extensive alopecia areata and was more recently approved for melanoma treatment as an orphan drug in the USA. Moreover, owing to the relative low cost and safety, topical immunotherapy has also been used in many infectious, neoplastic, and inflammatory dermatological diseases. It is especially valuable in vulnerable groups, for cosmetic/pain sensitive areas, or for multiple lesions. In this review, we summarize the current evidence supporting the use of contact immunotherapy for treatment of skin diseases, from articles collected from PubMed database. Owing to space limitation and already numerous studies focusing on alopecia areata, we include only skin diseases other than alopecia areata. In addition to diseases that have been reported to be treated by contact immunotherapy, the hypothesized mechanism, prognosis prediction, efficacy, and safety of these topical agents are discussed.

Alopecia Areata as a Manifestation of Systemic Lymphoma: Report of Two Cases

Alopecia areata is a common autoimmune disorder leading to hair loss. It usually affects individuals under the age of 40, and first appearance in older subjects is considered uncommon. Here, we report 2 cases of rapidly progressing alopecia areata, which appeared for the first time in adults. Patient 1 had alopecia universalis, which preceded the identification of hepatosplenic T-cell lymphoma, a rare form of lymphoma. Patient 2 suffered from the ophiasis type of alopecia areata, presenting for the first time following chemotherapy for non-Hodgkin B-cell lymphoma. These 2 cases highlight the need to screen for malignancies in patients who present with rapidly progressing alopecia areata for the first time after the age of 40.