P65: Retrospective analysis of the safety and appropriate use of 2,3-diphenylcyclopropenone in alopecia in a university teaching hospital

Z. Haider ¹ and A. Abdullah²

¹University Hospital Birmingham NHS Trust and ²Sandwell and West Birmingham NHS Trust, Birmingham, UK

Alopecia areata (AA) is a chronic inflammatory disease that predominantly affects the hair follicle. Commonly used treatments include topical and intralesional steroids. Treatment with contact immunotherapy with 2,3-diphenylcyclopropenone (DCP) can be used for patients with difficult-to-treat alopecia. There is a paucity of good-quality evidence related to use of DCP as treatment for alopecia. We carried out a retrospective analysis of 55 patients undergoing DCP treatment in a university teaching hospital treated from January 2017 to January 2020. Of 55 patients, 37 (67%) were female and 18 (33%) were male. About half of the patient cohort were < 18 years of age. Mean duration of disease was 5·5 years. Ninety-three per cent of patients were given a diagnosis of AA and 7% were given a diagnosis of alopecia universalis. On average, the duration of treatment was 16·74 months. Response outcomes were categorized as ‘complete hair growth’, ‘partial regrowth’, ‘none’ and ‘not known’. Forty-seven per cent of all patients did not have a clearly recorded response to treatment. From the data where defined responses were recorded, it is clear that there was a good response to treatment. Seventy-five per cent of patients with known outcomes had a response to treatment; of these patients, complete regrowth was noted in 32% and 43% had a partial response. Twenty-five per cent of patients had no regrowth. This is in line with published data. Breakdown of the adult and paediatric patient cohorts with known response outcomes demonstrated that adults had a better response to treatment, with complete hair growth noted in 55%. Thirty-six per cent of adult patients had a partial response and the rest had no hair growth. The paediatric population results for known responses was also favourable. Complete hair growth was noted in 37·5% of the paediatric cohort; a further 37·5% had partial regrowth. Of the 55 patients audited, 20 reported side-effects. The most common side-effect reported was blistering (n = 7). Other side-effects reported included mild dermatitis, erythema, irritation, hyperpigmentation and nonspecific reactions. Overall, the use of DCP is an effective and important specialist treatment option. Favourable results were seen in our patient cohort. The limitations in this analysis were the small sample size, potential reporting bias and lack of clear documentation. A clear and strategic plan has been put in place to help improve documentation and support for the clinic with plans to review the service again.