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Giornale Italiano di Dermatologia e Venereologia 1998 February;133(1):63-7

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Cyclosporine A-steroid association in pemphigus and pemphigoid treatment. Our experience in 14 cases

D’Onghia F. S., Chieregao C.

Università degli Studi - Verona, Istituto di Dermatologia e Venereologia (Direttore: Prof. C. Chieregato)


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Background and aim. Cyclosporine is a small lipophil peptide comprising 11 aminoacids, used for its immunosuppressive properties in the prevention and treatment of organ transplant rejection. In dermatology it is used with excellent results in psoriasis, lichen ruber planus and many other dermatosis with manifest or suspected immunomediated genesis. Owing to its immunosuppressive properties, it has also been used by some researchers to treat the group of pemphigus and pemphigoid dermatitis both in association with a steroid and in monotherapy. On the basis of the data reported by the literature and the authors’ personal experience of the use of cyclosporine in other dermatological pathologies, a therapeutic protocol was experimented using this drug in association with prednisone to treat patients suffering from pemphigus or pemphigoid.
Materials and methods. The study was performed in a group of 14 patients, 9 with pemphigus and 5 with pemphigoid, referred to the authors between January 1992 and June 1996. The study group included both patients who had not responded to earlier treatment, in particular steroid monotherapy, and patients in whom high-dose steroid treatment for long periods was contraindicated owing to the concomitant presence of systemic diseases like diabetes, osteoporosis, gastroduodenal ulcer, etc. The treatment protocol included the use of prednisone at a dose of 1.2-2 mg/kg/die in patients with pemphigus and 1-1.5 mg/kg/die in patients with pemphigoid. Cyclosporine was administered at a dose ranging between 3 and 5 mg/kg/die.
Results and conclusions. Compared to other studies based on the use of steroid monotherapy, the use of this protocol permitted a more rapid improvement of clinical conditions, a lower incidence of recidivation and the use of significantly lower cumulative steroid doses.

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