Long-term maintenance therapy with Cyclosporine A in adults with generalized pustular psoriasis

  • Kamel El-Reshaid
  • Al-Bader Shaima


Generalized pustular psoriasis (GPP) is a rare and serious immune-mediated skin disorder that is characterized by a widespread eruption of sterile and subcorneal pustules.  In the present study we investigated the efficacy of Cyclosporine A (Cy A) in treatment of 9 adults with drug-refractory GPP viz. topical Corticosteroids, retinoids, methotrexate and narrow-band ultraviolet light exposure (UVB).  Initially; they were resuscitated as burn patients. Cy A was administered on day 1 at a dose of 100 mg twice daily either in the form of syrup or Neoral capsules.  In most patients, skin lesions had healed by 6 weeks and the dose of Cy A was reduced to minimum to prevent further recurrence.  Seven patients had required 50 mg twice daily and 2 were controlled with 50 mg am and 25 mg pm.  On follow up, there was no serious relapse, liver and kidney disease.  Minor complications included; hirsutism and dark skin (n: 5) and gingival hyperplasia (n: 2). Trial to replace Cy A with Tacrolimus (Prograf) failed to maintain remission.  In conclusion; Cy A is a safe and effective treatment for GPP.

Keywords: Cyclosporin A, treatment, psoriasis, pustular.


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Author Biographies

Kamel El-Reshaid

Department of Medicine, Faculty of Medicine, Kuwait University, P O Box 24923, 13110 Safat, Kuwait              

Al-Bader Shaima

Asad Al-Hamad dermatology center, Ministry of health, Kuwait

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How to Cite
El-Reshaid K, Shaima A-B. Long-term maintenance therapy with Cyclosporine A in adults with generalized pustular psoriasis. JDDT [Internet]. 15Sep.2019 [cited 17May2024];9(5):19-1. Available from: https://jddtonline.info/index.php/jddt/article/view/3535