The Use of Cyclosporine in Dermatology

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


Luis Dehesa MD, Adriana Abuchar MD, Almudena Nuno-Gonzalez MD, Magalys Vitiello MD, and Francisco A. Kerdel BSc MBBS

Florida Academic Dermatology Center, University of Miami Hospital, Miami, FL

overall lack of controlled trials with cyclosporine in these diseases, due to the fact that in most of the cases, cyclosporine was used as a third-line treatment after other options failed. There are also isolated case reports where cyclosporine has shown good results, including diseases such as granuloma annulare in its elastolytic form,133 hypereosinophilic syndrome,134 Kimura's disease,135,136 eosinophilic pustulosis,137 metastatic Crohn's disease,138,139 necrobiosis lipoidica,140 panniculitis,141-143 IgA pemphigus,144 paraneoplastic pemphigus,145 impetigo herpetiformes, 146 sleromyxedema,147 and xanthomas.148

CONCLUSION

Although moderate to severe psoriasis remains the only FDAapproved indication for the use of cyclosporine in dermatology, the drug has been used with very good results for the treatment of multiple dermatologic conditions, including atopic dermatitis, neutrophilic dermatoses, connective tissue disorders, and autoimmune bullous diseases among others. In our opinion, cyclosporine plays an essential role in the dermatologic therapeutic arsenal due to its efficacy and rapid onset of action. Furthermore, short-term therapy and low doses translate into fewer side effects. It is also important to note that in dermatology, cyclosporine is frequently used as monotherapy and therefore the rates of complication are seen in a small percentage of patients.

DISCLOSURES

Dr. Kerdel has received grants, participated in advisory boards, and is a speaker for Abbott, Amgen, Wyeth, Astellas, Centocor, Genentech, Stiefel, Eisai, Pfizer, Celgene, Merck, and Novartis. Drs. Dehesa, Abuchar, Vitiello, and Nuno have disclosed no relevant conflicts of interest.

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