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August 9, 2019

The U.S. Food and Drug Administration recently approved the use of diphenylcyclopropenone (DPCP) as a bulk drug substance. DPCP may now, for the first time, be legally used for compound topical medications. Here’s more information about DPCP and the conditions the medication treats.

DPCP Is an Immunotherapeutic Agent

Since the 1970s, physicians have used topical immunotherapy to treat a variety of skin conditions. A topical drug treatment goes directly onto the skin versus conventional drug treatments that patients take orally or have injected into their body.

Before immunotherapy treatment with DPCP starts, the physician must sensitize the patient to DPCP. A health care professional applies a small test spot of highly concentrated DPCP on the patient’s skin. After several days, the DPCP causes allergic contact dermatitis.

After the initial sensitizing period, the patient (or a health care worker) applies a weaker solution of DPCP to their skin. The patient covers the site of DPCP application, since the drug breaks down when exposed to sunlight. The drug remains on the skin for a period of six to 24 hours before the patient washes the DPCP off their skin.

DPCP Immunotherapy Treats Alopecia Areata

Alopecia areata is an autoimmune skin disease affecting over six million people in the U.S. alone. The disease can affect people of all ages and ethnic groups.

One of the most common uses of DPCP is to treat alopecia areata. Alopecia areata is a medical condition that causes the hair to fall out of the scalp and other areas of the body. A notable feature of alopecia areata is hair loss that occurs in circular patches.

However, the hair follicles stay alive and may regrow hair any time in people with alopecia areata. DPCP topical immunotherapy is one of the treatments intended to stimulate the hair follicles of people who have this autoimmune disease.

According to dermatologists in Sydney, Australia, during studies of DPCP’s effectiveness in alopecia areata, topical treatment with the drug resulted in mild to excellent hair regrowth on the scalps of treated patients. The best results are seen in people who’ve suffered with alopecia areata for fewer than 10 years.

Patients have less success with DPCP treatment when they have substantial hair loss and/or atopic dermatitis. Experts recommend treating alopecia areata for at least six months if no initial progress exists with DPCP treatment. If the treatment works, it may take up to 12 months for hair growth to occur.

DPCP Therapy Has Become a Preferred Treatment for Warts

The human papillomavirus causes warts, which are benign skin tumors. Periungual warts are warts that develop near fingernails and/or toenails. The periungual wart is often hard to treat, because the warts grow larger with time and often come back after successful treatment.

Some treatments for periungual warts include liquid-nitrogen cryotherapy, laser therapy, and bleomycin treatment directly on the wart. However, many of the accepted treatments cause pain and/or scarring at the treatment site.

In a study at Dongguk University Ilsan Hospital in South Korea, researchers evaluated 27 patients with periungual warts after the patients received topical DPCP immunotherapy either alone or in combination with other treatments. When patients had successfully sensitization to the DPCP, the treatment’s success rate (meaning 100 percent eradication of warts) was 91 percent for the periungual warts.

Anogenital warts are papillomavirus-caused lesions that are painful and difficult to treat. Anogenital warts spread via sexual contact. However, children can sometimes acquire the virus through secondary or casual contact with adults who have the disease.

When children suffer with anogenital warts, clinicians often must anesthetize the pediatric patients due to the pain of conventional treatment methods.

However, according to Case Reports in Dermatology, physicians at Tokyo Women’s Medical University in Japan successfully treated three pediatric patients suffering from anogenital warts without destructive or highly painful therapies. The hospital’s Dermatology Department team treated the anogenital warts with topical DPCP.

The three toddlers received treatment with topical concentrations of DPCP between 0.05 percent and 0.5 percent and got rid of the warts after six months. Physicians involved with the toddlers’ treatment note the convenience of the DPCP therapy (since the treatment is applicable at home) and the lack of pain with the treatment. The physicians involved in the toddlers’ care suggest that DPCP therapy should be a preferred method of therapy for childhood anogenital warts.

DPCP Treatment Has Some Side Effects

While DPCP therapies are relatively pain-free, some patients do report side effects after treatment with the immunotherapy drug. Some side effects of DPCP include:

  • Swelling and redness
  • Widespread dermatitis
  • Hyperpigmentation, hypopigmentation, or vitiligo

You must store your compounded topical DPCP formulations in a dark glass container or other container that blocks sunlight. Compounded DPCP formulations are stable for up to six months.

If you live in Peoria, Arizona, and suffer from skin conditions including warts or alopecia areata, speak with your dermatologist about the pros and cons of compounded DPCP therapy for your condition. Then, contact Potter’s House Apothecary Inc. to professional and safely compound your topical medications for you.

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