Effectiveness of Cyclosporin A Therapy in Juvenile Generalised Pustular Psoriasis

Abstract

We report two cases of juvenile generalized pustular psoriasis treated with cyclosporin A. Case 1: A 6-year-old boy was treated with cyclosporin A at a dose of 5 mg/kg/day. Eruptions mostly disappeared within 1.5 months. Case 2: A 14-year-old girl was treated with cyclosporin A at a dose of 4.4 mg/kg/day. Eruptions were well controlled in two weeks. We discuss the dosage, effects, side effects and problems encountered during cyclosporin A therapy in seven cases including our two cases. The initial dose was 3~5 mg/kg/day and the mean duration of this therapy was 4.75 months. The disease was effectively controlled in all the cases within an average of 11.8 days. Relapses were observed in three cases during the period of reducing the dosage or after withdrawal. To prevent from relapses during the treatment with cyclosporin A, it is important to reduce doses slowly while monitering laboratory tests and clinical condition, to pay attention to infection and to use topical steroids or Vit D3 ointment in combination. To switch to PUVA therapy after completion of cyclosporin A therapy may be one way to control erupitons. Cyclosporin A is found to be more effective for the treatment of juvenile generalized pustular psoriasis in terms of its effectiveness and side effects than systemic corticosteroid or etretinate.