Topical cyclosporine for oral bullous disorders

Bullous and cicatricial pemphigoid and pemphigus vulgaris are disorders characterized by the appearance of painful skin blisters; pemphigus vulgaris involves other symptoms, as well, and can be fatal if untreated. Patients with any of these diseases can develop painful blisters in the mouth, and treatment is difficult because the sufferers are usually elderly and poorly tolerant of the toxic drugs used for therapy. Six patients with oral blisters were treated by swishing cyclosporine (an immunosuppressant drug) in their mouths three times daily for eight weeks. Results were positive for two patients with cicatricial pemphigoid and one with bullous pemphigoid, although two relapsed a few weeks after cyclosporine was stopped. Two of the three patients with pemphigus vulgaris also experienced reduction in pain and partial healing of the blisters. The remaining patient left the study before its completion because his disease needed additional treatment. Monitoring of liver, kidney, and blood showed no adverse effects from this dosage method of cyclosporine: efforts were made to verify that none had been swallowed. It is possible that the drug exerts a local effect on the tissue of the mouth, rather than a systemic effect. Further studies should be performed to evaluate the effectiveness of cyclosporine in diseases associated with severe oral blisters. (Consumer Summary produced by Reliance Medical Information, Inc.)