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Topical Immunotherapy: Step by Step

  • Colombina Vincenzi
  • Benedetta Marisaldi
  • Antonella Tosti
Chapter

Abstract

Alopecia areata (AA) is a T-cell-mediated autoimmune disease affecting genetically predisposed people of all ages (approximately 0.1–0.2% of the general population). It is a nonscarring alopecia that commonly affects the scalp with one or multiple patches, or the total scalp (alopecia totalis, AT), or the scalp and body hair (alopecia universalis, AU). There are no approved medical treatments, and the choice of treatment depends on the age of the patient, the extension, and the activity phase of the disease. Immunotherapy with squaric acid dibutylester (SADBE) or diphenylcyclopropenone (DPCP) is a topical treatment without serious side effects that can be prescribed also for children. The mechanism of action of this therapy is not fully understood, but studies have shown that the contact dermatitis induced by these sensitizers changes the perifollicular CD4+/CD8+ T-lymphocyte ratio, causes antigenic competition, leads to apoptosis of autoreactive T-lymphocytes, and modulates proinflammatory cytokines. Hair regrowth rates range from 6% to 85% as reported in different studies.

Keywords

Alopecia areata Alopecia areata of the eyebrows Alopecia areata of the beard Squaric acid dibutylester Diphenylcyclopropenone Topical immunotherapy Sensitization Hair regrowth T-lymphocyte Proinflammatory cytokines 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Colombina Vincenzi
    • 1
  • Benedetta Marisaldi
    • 1
  • Antonella Tosti
    • 2
  1. 1.Dermatology, Private Hospital NigrisoliBolognaItaly
  2. 2.Fredric Brandt Endowed Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

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