Is Diphencyprone a Cause or Trigger of Vitiligo? Insights From a Large Alopecia Areata Study Publisher



Rahimnia A ; Boroumand Sani S ; Ehsani A ; Koohian Mohammadabadi M ; Badeli J
Source: Iranian Journal of Dermatology Published:2026

Abstract

Background: Alopecia areata (AA) is an autoimmune disorder characterized by non-scarring hair loss. Diphencyprone (DPCP) is a commonly used topical immunotherapy for this condition. Although effective, DPCP has been associated with rare adverse effects, including vitiligo. The exact mechanism underlying DPCP-induced vitiligo remains unclear, and its prevalence among treated patients has not been well established. This study aims to determine the prevalence of this phenomenon in alopecia areata patients at Razi Dermatology Hospital. Methods: A retrospective study was conducted involving 458 patients with AA who received DPCP therapy at Razi Hospital from 2022 through the end of 2023. Patient demographics, disease characteristics, and vitiligo incidence were analyzed. The prevalence of vitiligo was compared with previously reported rates in AA patients, and potential risk factors were evaluated. Results: Among 458 AA patients treated with DPCP, 19 (4.1%) developed vitiligo. No significant differences were observed in gender distribution or AA subtypes. Vitiligo was more prevalent in younger patients and those with recent-onset disease. The prevalence of vitiligo in our study falls within the reported range for AA patients, suggesting that DPCP may act as a trigger rather than a direct cause. Interestingly, none of the patients who developed vitiligo had diabetes, potentially indicating a protective effect. Conclusion: DPCP-induced vitiligo is a rare but significant adverse effect, occurring in 4.1% of treated patients. The findings suggest that DPCP may unmask underlying vitiligo rather than directly causing it, likely through a Koebner phenomenon. Further studies are needed to clarify the risk factors and long-term outcomes. © Iranian Journal of Dermatology.