The Use of Cyclosporine in Dermatology

August 2012 | Volume 11 | Issue 8 | Original Article | 979 | Copyright © August 2012

paring methotrexate and cyclosporine, methotrexate was more effective controlling the muscle disease but cyclosporine was better in the treatment of associated interstitial lung disease.84 Several case reports of dermatomyositis with interstitial lung disease responding to cyclosporine and steroids can be found in the literature.85 Cyclosporine is also useful when there is esophageal involvement,86 showing better results than other immunosuppressive agents.84 In dermatomyositis sine myositis, cyclosporine can be useful, and there are cases showing good results.80,85 Amyopathic dermatomyositis is often associated to lung disease, including interstitial pneumonia, pneumomediastinum, and pulmonary fibrosis; cyclosporine is recommended due to its favorable effects in the lung and the speed of action.87
The optimal dose of cyclosporine is between 1.8 mg/kg/day and 3.5 mg/kg/day combined with prednisone 1 mg/kg/day gradually tapered.81,82
Thus, cyclosporine can be used in dermatomyositis as a second line treatment as a steroid-sparing agent and is especially useful in patients with interstitial lung disease or esophageal involvement.
Other Diseases
There are many other skin diseases for which cyclosporine is a good treatment option (Table 1).88-132 Most of these are series of cases and reviews of the literature (evidence III). There is an