Cyclosporin A in the treatment of severe atopic dermatitis and palmoplantar pustulosis

BACKGROUND/AIMS: Cyclosporin A is useful in the treatment of psoriasis, atopic dermatitis and other dermatoses. The aim of this longterm study was to investigate the usefulness of cyclosporin A in the treatment of severe and therapy-resistant atopic dermatitis and also in palmoplantar pustulosis. METHODS: This study was performed in two series, one of 18 patients with severe atopic dermatitis, the other one of 36 patients with palmar or palmo-plantar pustulosis. In both series the schedule of treatment consisted of four consecutive stages: in the first stage the patients received cyclosporin A 2.5 mg/kg per day for 3 months; in the second stage 2 mg/kg per day for 6 months; in the third stage 1.2 mg/kg per day also for 6 months; and in the fourth stage the doses were the same as in the third but on alternate days. The fifth stage was a follow-up period, 9 months for patients without recurrences until then and 3 months if there was any recurrence or if the patient had relapsed in an earlier stage. RESULTS: This regimen of treatment was effective in 91.6% of cases of palmoplantar pustulosis and in 73.7% of cases of severe atopic dermatitis, Side-effects, when present, were slight. CONCLUSION: A low dose treatment regimen of CyA is both efficient and has very few side effects.