Treatment of adult atopic dermatitis with low-dose (3 mg/kg per day) cyclosporine

A group of 18 adult patients, with chronic, severe and therapy-resistant atopic dermatitis, were treated with 3 mg/kg per day cyclosporine for 1-8 months (mean 5.3 months). All patients were treated in the period from September-October to April-May. During the summer months only exposure to sunlight was recommended. In 15 patients improvement in clinical signs and pruritus, and a beneficial impact on the quality of life were observed. Side-effects occurred in 6 patients, but they did not lead to suspension of therapy. No changes in blood pressure were observed. No renal or hepatic side-effects were recorded. During follow-up (ranging from 17 to 42 months, with a mean of 23.8 months), 11 patients were in good health and the dermatitis was controlled with topical nonsteroidal products and exposure to sunlight. Four patients developed a relapse for which therapy with cyclosporine was again started. Cyclosporine can be successfully used in the treatment of adult patients with chronic, severe and therapy-resistant atopic dermatitis and it appears to be effective even at a dose of 3 mg/kg per day. Low-dose long-term treatment can lead in some patients to complete remission of the disease. The proposed therapeutic regimen (treatment from September-October to April-May and only exposure to sunlight during the summer months) is innovative and is particularly suited to the Mediterranean and similar climates.