Alopecia areata incognita (AAI) – characterized by widespread hair thinning in the absence of typical alopecic patches, predominantly affects females. AAI can have a chronic relapsing course, and may also be resistant to standard treatments.

A new study published in Dermatologic Therapy evaluated the efficacy and tolerance of topical immunotherapy with squaric acid dibutylester (SADBE) in AAI, not responding to conventional steroid therapy.

This single-center, pilot study enrolled 12 individuals with proven histological diagnosis of AAI who were resistant to classical steroid therapy.

The findings showed complete regrowth in 66.7%% of the cases. While three patients showed only subclinical improvement on trichoscopy. On the other hand, one patient progressed and then worsened, on clinical and trichoscopic examinations. All patients experienced diffuse mild erythema and itching of the scalp, the day after the application of SADBE—which were well tolerated. However, three patients developed reactive cervical lymphoadenomegaly.

It was concluded that topical immunotherapy with SADBE is an effective alternative in treating resistant AAI. This modality renders visible clinical and trichoscopic improvement in majority of the cases.

Source: Dermatologic Therapy. 2021 Aug 14. doi: 10.1111/dth.15096.