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Giornale Italiano di Dermatologia e Venereologia 2002 April;137(2):135-40

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Cyclosporin-A in cutaneous adverse drug reactions. A new therapeutical approach?

Congedo M., Nettis E., Ferrannini A., Quarta G.

Azienda Ospedaliera «V. Fazzi» - Lecce UO di Dermatologia *Università degli Studi - Bari Cattedra di Allergologia ed Immunologia


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Background. The function of T-lymphocytes in cutaneous adverse drug reactions (CADR) has not been fully evaluated. There are some experimental data showing that drug-induced maculo-papular exanthemas are determined by an immunological mechanism mediated by T-lymphocytes. In this study, we have investigated the clinical role of cyclosporin A in drug-induced exanthemas in which a T-cell-mediated immune response was probably operative.
Methods. We have used cyclosporin-A in 7 patients (6 F-1 M, with age ranging from 54 to 76 years) affected by CADR with clinical signs indicating a T-cell-mediated immune response. Cyclosporin A was given at a dosage ranging from 3,5 to 5 mg/kg/day with a maximum duration of 10 days (mean duration of the treatment 7,8 days). In four patients, the soluble IL-2 receptor (sIL-2R) was evaluated as marker of circulating T-cells activation.
Results. For all patients symptoms improved within 48 hours and disappeared within 10 days. There were no significant side effects or alterations of blood pressure and clinical laboratory parameters in any case. The serum levels of sIL-2R were reduced after therapy in all the cases evaluated.
Conclusions. These results indicate the effectiveness of cyclosporin A for the treatment of CADR. The increased serum levels of sIL-2R before therapy and their normalization after therapy are consistent with an immunopathologic role of activated CD8+ cytotoxic lymphocytes. This T-cell-mediated immune response is probably inhibited by cyclosporin A at a low dosage ranging from 3,5 to 5 mg/kg/day.

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