title: Delayed-type hypersensitivity in palmoplantar pustulosis: effect of cyclosporin A treatment on skin testing with recall antigens.
abstract: Delayed-type hypersensitivity reactions to skin antigens are an indirect measure of cellular immune response. We studied in a double-blind manner whether clinically effective doses of cyclosporin A in palmoplantar pustulosis would diminish delayed-type hypersensitivity reactions in vivo. For testing delayed-type hypersensitivity, we applied intradermally a standardized panel of seven recall antigens and a vehicle control in 30 patients with palmoplantar pustulosis, and 28 were tested both at baseline and after 4 weeks. For 4 weeks 14 patients were treated with 2.5 mg/kg/day cyclosporin A and 14 patients with placebo. Cyclosporin A but not placebo caused a significant decrease in clinical disease parameters. In contrast, no significant differences in delayed-type hypersensitivity reactions between treatment groups were observed. The results do not support the view that the efficacy of low-dose cyclosporin A in dermatological disorders can be entirely explained by cyclosporin A's inhibitory actions on effector T-cells.
authors.affiliation: Department of Dermatology, Helsinki University Central Hospital, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Remitz
authors.forename: A I
authors.initials: AI
authors.lastname: Lauerma
authors.forename: P
authors.initials: P
authors.lastname: Erkko
authors.forename: S
authors.initials: S
authors.lastname: Reitamo
mesh_terms: D000328:Adult; D000941:Antigens; D000942:Antigens, Bacterial; D000946:Antigens, Fungal; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D004168:Diphtheria Toxoid; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000188:drug therapy* / Q000276:immunology; D007111:Immunity, Cellular; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D014677:Pharmaceutical Vehicles; D010919:Placebos; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology; D012867:Skin / Q000187:drug effects / Q000276:immunology*; D012882:Skin Tests; D013601:T-Lymphocytes / Q000187:drug effects; D013745:Tetanus Toxoid; D014374:Tuberculin Test
chemical_list: D000941:Antigens; D000942:Antigens, Bacterial; D000946:Antigens, Fungal; D004168:Diphtheria Toxoid; D007166:Immunosuppressive Agents; D014677:Pharmaceutical Vehicles; D010919:Placebos; D013745:Tetanus Toxoid; D016572:Cyclosporine