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Topical immunotherapy: unapproved uses, dosages, or indications

      T opical immunotherapy involves the therapeutic use of contact sensitizers on the skin, and it has been tried in a wide variety of disorders in which alterations in cutaneous immunology are thought to be central to the pathogenesis, including autoimmune diseases,
      • Mitchell A.J.
      • Krull E.A.
      Alopecia areata pathogenesis and treatment.
      inflammatory dermatoses,
      • Kano Y.
      • Otake Y.
      • Shiohara T.
      Improvement of lichen nitidus after topical dinitrochlorobenzene.
      infections,
      • Lewis H.M.
      Topical immunotherapy of refractory warts.
      and cutaneous malignancy.
      • Williams A.C.
      • Klein E.
      Experiences with local chemotherapy and immunotherapy in premalignant and malignant skin lesions.
      Topical immunotherapy, however, has been most widely used in the treatment of alopecia areata (AA) and recalcitrant viral warts, and this review will focus on these two areas.
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      References

        • Mitchell A.J.
        • Krull E.A.
        Alopecia areata.
        J Am Acad Dermatol. 1984; 11: 763-775
        • Kano Y.
        • Otake Y.
        • Shiohara T.
        Improvement of lichen nitidus after topical dinitrochlorobenzene.
        J Am Acad Dermatol. 1998; 1998: 305-308
        • Lewis H.M.
        Topical immunotherapy of refractory warts.
        Cutis. 1973; 12: 863-867
        • Williams A.C.
        • Klein E.
        Experiences with local chemotherapy and immunotherapy in premalignant and malignant skin lesions.
        Cancer. 1970; 25: 450-462
        • Rhodes E.L.
        • Dolman W.
        • Kennedy C.
        • Taylor R.R.
        Alopecia areata regrowth induced by Primula obconica.
        Br J Dermatol. 1981; 104: 339-340
        • Helm F.
        • Klein E.
        • Traenkle H.L.
        • Rivera E.P.
        Studies on the local administration of 2,3,5-triethylene-imino-1,4-benzoquinone(trenimom) to epitheliomas.
        J Invest Dermatol. 1965; 45: 152-159
        • Dunaigin W.G.
        Use of dinitrochlorobenzene (DNCB) in therapy of warts.
        J Am Acad Dermatol. 1984; 10: 1069
        • Happle R.
        • Kalveram U.
        • Büchner K.
        • et al.
        Contact allergy as a therapeutic tool for alopecia areata.
        Dermatologica. 1980; 161: 289-297
        • van der Steen P.H.M.
        • Happle R.
        Topical immunotherapy of alopecia areata.
        Dermatol Clin. 1993; 11: 619-623
        • Shapiro J.
        Topical immunotherapy in the treatment of chronic severe alopecia areata.
        Dermatol Clin. 1993; 11: 611-617
        • Wilkerson M.G.
        • Connoe T.H.
        • Wilkin J.K.
        Dinitrochlorobenzene is inherently mutagenic in the presence of trace mutagenic contaminants.
        Arch Dermatol. 1988; 124: 396-398
        • Hausen B.M.
        • Stute J.
        Diphenylcyclpropenone.
        Chem Industry. 1980; 17: 699-700
        • Buckley D.A.
        • du Vivier A.W.P.
        The therapeutic use of topical contact sensitizers in benign dermatoses.
        Br J Dermatol. 2001; 145: 385-405
        • Happle R.
        • Hausen B.M.
        • Wiesner-Menzel I.
        Diphencyprone in the treatment of alopecia areata.
        Acta Dermatovenereol (Stockholm). 1983; 63: 49-52
        • MacDonald Hull S.
        • Cunliffe W.J.
        Successful treatment of alopecia areata using the contact allergen diphencyprone.
        Br J Dermatol. 1991; 124: 212-213
        • Hatzis J.
        • Georgiotouo K.
        • Kostakis P.
        • et al.
        Treatment of alopecia areata with diphencyprone.
        Australas J Dermatol. 1988; 29: 33-35
        • Sharma V.K.
        • Muralidhar S.
        Topical immunotherapy with diphencyprone in Indians with alopecia areata.
        Clin Exp Dermatol. 1998; 23: 290-299
        • Orecchia G.
        • Rabbiosi G.
        Treatment of alopecia areata with diphencyprone.
        Dermatologica. 1985; 171: 193-196
        • Monk B.
        Induction of hair growth in alopecia totalis with diphencyprone sensitization.
        Clin Exp Dermatol. 1989; 14: 154-157
        • Ashworth J.
        • Tuyp E.
        Allergic and irritant contact dermatitis compared in the treatment of alopecia totalis and universalis.
        Br J Dermatol. 1989; 120: 397-401
        • Gordon P.M.
        • Aldridge R.D.
        • McVittie E.
        • Hunter J.A.A.
        Topical diphencyprone for alopecia areata.
        Br J Dermatol. 1996; 134: 869-871
        • Tosti A.
        • De Padova M.P.
        • Minghetti G.
        • Veronesi S.
        Therapies versus placebo in the treatment of patchy alopecia areata.
        J Am Acad Dermatol. 1986; 15: 209-210
        • Hoting E.
        • Boehm A.
        Therapy of alopecia areata with diphencyprone.
        Br J Dermatol. 1992; 127: 625-629
        • Naldi L.
        • Parazzini F.
        • Cainelli T.
        • Reading Group
        Role of topical immunotherapy in the treatment of alopecia areata.
        J Am Acad Dermatol. 1990; 22: 654-656
        • Rokhsar C.K.
        • Shupack J.L.
        • Vafai J.J.
        • et al.
        Efficacy of topical sensitizers in alopecia areata.
        J Am Acad Dermatol. 1998; 39: 751-761
        • Wiseman M.C.
        • Shapiro J.
        • MacDonald N.
        • Lui H.
        Predictive model for immunotherapy of alopecia areata with diphencyprone.
        Arch Dermatol. 2001; 137: 1063-1068
        • MacDonald Hull S.
        • Wood M.
        • Messenger A.
        Guidelines for the management of alopecia areata.
        Br J Dermatol. In press;
        • Schuttelaar M.-L.A.
        • Hamstra J.J.
        • Plinck E.P.B.
        • et al.
        Alopecia areata in children.
        Br J Dermatol. 1996; 135: 581-585
        • Weise K.
        • Kretzschmar L.
        • John S.M.
        • Hamm H.
        Topical immunotherapy in alopecia areata.
        Dermatology. 1996; 192: 129-133
        • Happle R.
        Diphencyprone for the treatment of alopecia areata; more data and new aspects.
        Arch Dermatol. 2002; 138 ([editorial]): 112-113
        • Valsecchi R.
        • Cainelli T.
        • Foiadelli L.
        • Rossi A.
        Topical immunotherapy of alopecia areata.
        Acta Dermatovenereol (Stockholm). 1986; 66: 269-272
        • Ochsendorf F.R.
        • Mitrou G.
        • Milbradt T.
        Therapie der Alopecia areata mit diphenylcyclopropenon.
        Z Hautkr. 1988; 63: 94-100
        • Berth-Jones J.
        • McBurney A.
        • Hutchinson P.E.
        Diphencyprone is not detectable in serum or urine following topical application.
        Acta Dermatovenereol (Stockholm). 1994; 74: 312-313
        • Henderson C.A.
        • Ilchyshyn A.
        Vitiligo complicating diphencyprone sensitization therapy for alopecia universalis.
        Br J Dermatol. 2002; 133: 496-497
        • van der Steen P.H.M.
        • Happle R.
        ‘Dyschromia in confetti’ as a side effect of topical immunotherapy with diphencyprone.
        Arch Dermatol. 1992; 128: 518-520
        • Fernandez-Redondo V.
        • Gomez-Centeno P.
        • Florez A.
        • Toribio J.
        Hazards in the use of diphencyprone.
        Allergy. 2000; 55: 202-203
        • MacDonald-Hull S.
        • Cotterill J.A.C.
        • Norris J.F.B.
        Vitiligo following diphencyprone dermatitis.
        Br J Dermatol. 1989; 120: 323
        • Sansom J.E.
        • Molloy K.C.
        • Lovell C.R.
        Occupational sensitization to diphencyprone in a chemist.
        Contact Derm. 1995; 32: 363
        • Adisesh A.
        • Beck M.
        • Cherry N.M.
        Hazards in the use of diphencyprone.
        Br J Dermatol. 1997; 136: 465-479
        • Bircher A.J.
        • Bigliardi P.
        • Langauer-Messmer S.
        • Surber C.
        Occupational airborne contact dermatitis from diphencyporne in a pharmacy employee.
        Contact Derm. 1999; 41: 52
        • Shah M.
        • Lewis F.M.
        • Messenger A.G.
        Hazards in the use of diphencyprone.
        Br J Dermatol. 2002; 134: 1153
        • MacDonald-Hull S.
        • Pepall L.
        • Cunliffe W.J.
        Alopecia areata in children.
        Br J Dermatol. 1991; 125: 164-168
        • Tosti A.
        • Guidetta M.S.
        • Bardazzi F.
        • et al.
        Long term results with topical immunotherapy in children with alopecia totalis or universalis.
        J Am Acad Dermatol. 1996; 35: 199-201
        • Schmoeckel C.
        • Weissmann I.
        • Plewig G.
        • Braun-Falco O.
        Treatment of alopecia areata by anthralin-induced dermatitis.
        Arch Dermatol. 1979; 115: 1254-1255
        • MacDonald-Hull S.
        • Cunliffe W.J.
        Alopecia areata treated with diphencyprone.
        Br J Dermatol. 1990; 122: 716-717
        • Orecchia G.
        • Perfetti L.
        Alopecia areata and topical sensitizers.
        Br J Dermatol. 1999; : 509
        • Happle R.
        Antigenic competition as a therapeutic concept for alopecia areata.
        Arch Dermatol Res. 1980; 267: 109-114
        • Gülekon A.
        • Gürer M.A.
        • Bozkurt M.
        • Keskin N.
        The effects of DNCB therapy on T-cell subsets of the cases with alopecia areata.
        Int J Dermatol. 1989; 28: 684-685
        • Galbriath G.M.
        • Pandey J.P.
        Tumour necrosis factor alpha (TNF-α) gene polymorphisms in alopecia areata.
        Hum Genet. 1995; 96: 433-436
        • Tarlow J.K.
        • Clay E.E.
        • Cork M.J.
        • et al.
        Severity of alopecia areata is associated with a polymorphism in the interleukin-1 receptor antagonist gene.
        J Invest Dermatol. 1994; 103: 387-390
        • Bröcker E.-B.
        • Echternacht-Happle K.
        • Hamm H.
        • Happle R.
        Abnormal expression of class I and class II major histocompatibility antigens in alopecia areata.
        J Invest Dermatol. 1987; 88: 564-568
        • Buckley D.A.
        • Keane F.M.
        • Munn S.E.
        • et al.
        Recalcitrant viral warts treated by diphencyprone immunotherapy.
        Br J Dermatol. 1999; 141: 292-296
        • Orecchia G.
        • Douville H.
        • Santagostino L.
        • Rabbiosi G.
        Treatment of multiple relapsing warts with diphencyprone.
        Dermatologica. 1988; 1988: 225-231
        • Claudy A.L.
        • Roche H.
        • Gogue Y.
        Traitement des verrues multiples et récidivantes par induction d’une hypersensibilité retardée.
        Ann Dermatol Vennereol. 1981; 108: 765-767
        • Wiesner-Menzel L.
        • Happle R.
        Ruckbildung von Plantarwartzen nach Behandlung mit Diphencyprone.
        Z Hautkr. 1984; 59: 1080-1083
        • Rampen F.H.J.
        • Steijlen P.M.
        Diphencyprone in the management of refractory palmoplantar and periungual warts.
        Dermatology. 1996; 193: 236-238
        • Lane P.R.
        • Hogan D.J.
        Diphencyprone.
        J Am Acad Dermatol. 1988; 19: 364-365
        • Naylor M.F.
        • Neldner K.H.
        • Yarborough G.K.
        • et al.
        Contact immunotherapy of resistant warts.
        J Am Acad Dermatol. 1988; 19: 679-683
        • Georgala S.
        • Danapoulou I.
        • Katsarou A.
        Dinitrochlorobenzene treatment of condyloma acuminata.
        Australas J Dermatol. 1989; 30: 103-105
        • van der Steen P.
        • van de Kerkhof P.
        • der Kinderen D.
        • et al.
        Clinical and immunohistochemical responses of plantar warts to topical immunotherapy with diphencyprone.
        J Dermatol. 1991; 18: 330-333
        • Eriksen K.
        Treatment of the common wart by induced allergic inflammation.
        Dermatologica. 1980; 160: 161-166
        • Puig L.
        • Alegre M.
        • Cuatrecasas M.
        • Moragas J.M.
        Erythema multiforme-like reaction following diphencyprone treatment of plane warts.
        Int J Dermatol. 1994; 33: 201-203
        • Harland C.
        • Saihan E.M.
        Regression of cutaneous metastatic malignant melanoma with topical diphencyprone and oral cimetidine.
        Lancet. 1989; : 445
        • Traub A.
        • Margulis S.B.
        • Stricker R.B.
        Topical immunomodulation with DNCB in HIV disease.
        Dermatology. 1997; 195: 369-373