摘要：【目的】探讨难治性斑秃患者局部外用二苯环丙烯酮（DPCP）的疗效及其影响因素。【方法】回顾性分析127例难治性斑秃患者外DPCP的有效率、不良反应、复发率和再次治疗的有效率，并分析临床资料、皮肤镜征象、检验指标对疗效的影响。【结果】本组难治性斑秃患者DPCP 治疗治愈率、有效率分别为37.1%、44.8%，复发率36.5%，复发后再治疗有效率为63.2%。26.8%患者出现较明显副作用如严重接触性皮炎、泛发性接触性皮炎、白癜风等。发病年龄早、病程长、稳定期、脱发面积大、斑秃类型为全普秃和带状型、皮肤镜黑点断发征像阴性者疗效差（P 值分别是0.016、0.093、0.003、0.031、0.002和0.006）。【结论】外用DPCP治疗难治性斑秃疗效确切且相对安全，尤其是对于脱发面积小、病程短、活动期时治疗效果最佳。但目前DPCP疗法仍待进一步改良，以提高难治性斑秃的有效率。

Abstract：【Objective】To investigate the therapeutic effect of diphenylcyclopropenone（DPCP）topical immunotherapy in refractory alopecia areata（AA）patients and its influencing factors in Chinese population.【Methods】127 refractory and severe alopecia areata patients in Chinese population treated with DPCP were retrospectively analyzed and the influence of clinical manifestations，dermotoscopy signs and laboratory markers on treatment was also investigated. 【Results】The curative rate was 37.1% and the response rate 44.8%. However，a relapse rate of 36.5% was observed and the effective rate of treatment after relapse was 63.2%. 26.8% of the patients suffered from relatively severe side effects consisting of severe contact dermatitis，systemic contact dermatitis，vitiligo and so on. Effectiveness of treatment correlated negatively with early onset age，long disease duration，stable phase，extensive hair loss area，type of alopecia areata universalis or totalis or ophiasis，negative signs of black dots or broken hairs under dermatoscope（P = 0.016，0.093，0.003，0.031，0.002，0.006 respectively）.【Conclusion】DPCP topical immunotherapy treatment is a relatively safe and effective way in treating refractory and severe AA patients in Chinese population. The best efficacy is achieved especially when hair loss area is not extensive，short disease course and active phase existing. However，further modified DPCP treatments are urgently needed to improve the response rate.

​詹济滂，叶艳婷，薛紫，高雪梅，杨建，章星琪 2018 Vol. 39(5): 693-701