Background: Topical immunotherapy has been used in the treatment of children with alopecia areata with encouraging results. Objective: Our purpose was to determine the long-term results in 33 children with severe alopecia areata treated with topical immunotherapy. Methods: From 1983 to 1989 we treated 33 children with topical immunotherapy with squaric acid dibutylester. Results: Complete hair regrowth was observed in 10 children (30.3%). During the follow-up period (mean, 5.9 years; range, 4 to 12 years), 7 of these 10 patients had severe relapses that were not responsive to further treatment. Only three clinically benefited from topical immunotherapy. Two maintained complete hair regrowth after treatment was stopped. Conclusion: Our results indicate that only a small proportion of children with severe alopecia areata will obtain a persistent benefit from topical immunotherapy.
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