An Easy, Cheap, and User-Friendly Technique for Topical Immunotherapy With Diphencyprone: Cotton Tip Injector Technique.

Topical immunotherapy with diphencyprone (DPCP) is an effective treatment option in alopecia areata. This treatment should be performed very carefully following a standard protocol application.

Health care professionals are advised to take proper precautions. The solution is applied on the scalp with a cotton swab. Muthuvel recommends“fast applications” to cover entire scalp before acetone starts evaporating.[1] Evaporation of acetone can cause a change in the concentration of the solution, which may lead to more irritation, swelling, and disturbance of the treatment protocol. In our technique, the planned concentration of DPCP in acetone is drawn into the syringe to avoid evaporation. The needle of syringe is removed and a shortened cotton tip is placed to the endof the syringe. With the help of gravity and capillary flow principle, the DPCP solution slowly moves to the cotton tip only allowing dampening by slightly pressing the syringe without spilling [Figure 1a and b]. With this application technique, DPCP solution can be easily and safely applied on affected areas [Figure 1c].

Figure 1

(a) Cotton tip applicator with hollow tube. (b) Syringe is filled with solution and instead of the needle shortened cotton tip is inserted in to the syringe. (c) A safe closed system with a soft application tip is ready to use

There are many solutions in dermatology practice that can be applied with using only a cotton tipapplicator. Cotton tip applicator is a multipurpose and cost-effective tool in dermatology.[2] However, some solutions like DPCP are dissolved in acetone and changes in concentrations level due to evaporation is an obstacle to overcome. Here, the cotton tip injector technique is described. As it minimizes the evaporation surface compared to applications from a petri box, it helps the physician to ensure the concentration of DPCP in a closed system during application. We suggest that this easy, low-cost, and user-friendly technique can be useful to reduce the side effects and improve patient compliance during DPCP treatment.

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Conflicts of interest

There are no conflicts of interest.