{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:03:27Z","timestamp":1790244207370,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,10,18]],"date-time":"2013-10-18T00:00:00Z","timestamp":1382054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Topical immunotherapy with diphenylcyclopropenone (<jats:styled-content style=\"fixed-case\">DPCP<\/jats:styled-content>) is a treatment that can be used in patients with alopecia areata (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>) with more than 50% involvement of the scalp. The aim of this study is to assess the response of our patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> treated with topical immunotherapy with <jats:styled-content style=\"fixed-case\">DPCP<\/jats:styled-content> at the American University of Beirut\u2010Medical Center (<jats:styled-content style=\"fixed-case\">AUB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>) and to characterize the favorable prognostic factors that predict response to treatment. This is a retrospective study of all patients diagnosed with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> at <jats:styled-content style=\"fixed-case\">AUB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> and treated with topical immunotherapy with <jats:styled-content style=\"fixed-case\">DPCP<\/jats:styled-content> over a period of 10\u00a0years. A total of 34 cases were included for analysis (19 males and 15 females). The majority of patients had limited <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (58.8%) with a mean of 39% of scalp involvement. The remaining patients had alopecia universalis (29.4%) and alopecia totalis (11.8%). The percentage of patients that responded to <jats:styled-content style=\"fixed-case\">DPCP<\/jats:styled-content> therapy in our series was 79.4% (<jats:italic>n<\/jats:italic>\u00a0=\u00a027). Ten patients achieved a maximal grade of 3 following treatment, six patients only achieved a grade of 1, and six patients achieved a grade of 2. Only five of the patients who responded to therapy achieved a grade of 4. Of the patients who responded, 10 relapsed (29.4%), and the mean time to relapse was 74.6\u00a0weeks from the initiation of treatment. No specific favorable prognostic factors were identified to predict response to treatment; however, a negative family history of atopy was found to be protective against relapse (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.020). The most common side effect of therapy was itching (85.3%), followed by contact dermatitis (58.8%), blistering (17.6%), and cervical lymphadenopathy (17.6%). Limitations of this study were the retrospective nature of the study and the limited number of patients. This is, to the best of our knowledge, the first study on topical immunotherapy with <jats:styled-content style=\"fixed-case\">DPCP<\/jats:styled-content> in patients with extensive <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> from a Middle Eastern population. This modality of treatment is effective in inducing a response in patients with extensive <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>, although the response is partial in the majority of the cases. Benefits should be weighed against the high side\u2010effect profile of therapy before initiation of treatment.<\/jats:p>","DOI":"10.1111\/ijd.12226","type":"journal-article","created":{"date-parts":[[2013,10,18]],"date-time":"2013-10-18T07:01:17Z","timestamp":1382079677000},"page":"1551-1556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Topical immunomodulation with diphenylcyclopropenone for alopecia areata: the Lebanese experience"],"prefix":"10.1111","volume":"52","author":[{"given":"Jinane","family":"El Khoury","sequence":"first","affiliation":[{"name":"Department of Dermatology American University of Beirut Medical Center Beirut Lebanon"},{"name":"Department of Biochemistry and Molecular Genetics American University of Beirut Medical Center Beirut Lebanon"},{"name":"Department of Dermatology Columbia University Medical Center New York NY 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