Treatment of resistant severe psoriasis with systemic cyclosporine.
Four patients with severe psoriasis have been treated with oral cyclosporine for 6 months. Two had generalized erythroderma and two had extensive plaque-type psoriasis; all had either become unresponsive to or were unable to use other accepted treatments. All four patients responded rapidly and were completely clear of psoriasis within 3 weeks of beginning therapy. Initial doses ranged from 7.5 to 8.5 mg/kg/day. Mild reversible nephrotoxicity occurred in the one patient whose cyclosporine trough level briefly exceeded 200 ng/ml. Cyclosporine may offer an alternative therapeutic modality in the management of erythrodermic or severe resistant plaque-type psoriasis. The effectiveness of cyclosporine in psoriasis underscores the putative role of cell-mediated immune factors in the pathogenesis of psoriasis.
Picascia
D D
DD
Department of Dermatology, Northwestern University Medical School, Chicago, IL 60611.
Garden
J M
JM
Freinkel
R K
RK
Roenigk
H H
HH
D000284:Administration, Oral; D000328:Adult; D003524:Cyclosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology; D013997:Time Factors
D003524:Cyclosporins