Simeen Ber Rahman, Amer ljaz, Tariq Malik, Ashfaq Ahmad Khan.
Use of cyclosporin-A (sandimmun neoral) in severe refractory atopic dermatitis.
Pak J Pathol Jan ;10(4):19-22.

Atopic dermatitis is an intensely pruritic condition with an unknown etiology but with a genetic predisposition. It is associated with T cell mediated mechanism and IgE mediated reactivity. Due to intense pruritus the quality of life can be seriously affected. Although most patients respond to the standard antihistaminic, emollients, and topical corticosteroid applications, a percentage of patients do not respond well and develop a refractory severe form of the disease. Various drugs have been tried in these patients. Cyclosporin A has been used as an effective treatment in severe atopic dermatitis. A trial was conducted in this centre to evaluate the efficacy, tolerability, safety and maintenance of remission in our patients of severe refractory atopic dermatitis. 25 cases were selected, age was between 15-25 years. 10 weeks therapy of cyclosporin A (sandimmun neoral) was given as capsules and drops. At the end of 3 month follow up period an improvement was seen in all patients. 90-100% improvement was seen in 14%, more then 50% improvement was seen in 64% and less then 50% improvement was seen in 28% cases. Our patients saw no major side effects and the drug was well tolerated.

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