Long-term administration of cyclosporin A to HCV-antibody-positive patients with dermatologic diseases.
BACKGROUND
Cyclosporine A (CYA) is an immunosuppressive agent which is being used in the treatment of an increasingly wide range of dermatologic diseases, but its use has been avoided in carriers of hepatitis C virus (HCV).


METHODS
We administered small doses of CYA (maximum, 3 mg/kg/day) for a long time to treat dermatologic diseases in one HCV-antibody-positive patient with no HCV-RNA in the blood, one patient with a small amount of HCV-RNA in the blood, and two patients with large amounts of HCV-RNA in the blood.


RESULTS
Skin lesions improved in all patients, but recurred upon complete or partial withdrawal of CYA. In the absence of HCV-RNA in the blood, or when only a small quantity of HCV-RNA was present in the blood, HCV-RNA load showed no apparent change. In one patient with a large blood HCV-RNA load, CYA dosage reduction was followed by increases in alanine aminotransferase (ALT) levels and decreases in blood HCV-RNA. Aggravation of hepatitis due to immunologic reactivation was suspected in this patient.


CONCLUSIONS
The reduction of CYA dosage is a key element in the use of this agent for cutaneous diseases.
D000368:Aged; D000369:Aged, 80 and over; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000187:drug effects; D012008:Recurrence; D012871:Skin Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors