Effectiveness of cyclosporine treatment in severe psoriasis: a clinical and immunologic study

An open clinical study on hospitalized patients was carried out to determine the effectiveness of cyclosporine, a drug that suppresses the immune system, on severe psoriasis. Disease status, as determined by the Psoriasis Area and Severity Index (PASI) and by measurement of several blood chemistry variables, was reviewed weekly in all subjects, and, in addition, analysis of small skin biopsies was performed on about half the group. The biopsies were examined for presence of different cell types and were evaluated for blood cell function, with emphasis on factors associated with the cell-mediated immune response. Results indicated that most (12/13) patients went into remission and that improvement in their appearance was almost complete after 20 days of treatment. Patients with psoriatic arthropathy (joint inflammation) experienced relief of pain and improved function. Most substances quantified in blood tests remained within normal levels. The majority of cells found under the psoriatic lesions were immune cells, namely T cells, with a prevalence of active T helper cells, and the number of these diminished as treatment progressed. Changes in other cell types associated with the cell-mediated immune response were noted. These results are in agreement with other studies on the effects of cyclosporine on psoriasis. Side effects of this drug can be dangerous, and its use in psoriasis patients should be restricted to patients who can be carefully observed. (Consumer Summary produced by Reliance Medical Information, Inc.)