Seema (Sherali) Hirji, Anjum Kanjee.
Use of Cyclosporin A in the treatment of Acute Generalized Pustular Psoriasis.
J Pak Assoc Derma Jan ;11(4):48-53.

Psoriasis is a chronic, long-standing disease lasting decades, characterized by exacerbation and remissions. The exact course of the cycles of waxing and waning of disease expression is highly variable. In pustular psoriasis, sterile pustules form on inflamed, erythematous skin. Although it is uncommon, pustular psoriasis may progress to involve the entire body, accompanied by leukocytosis, fever and other toxic reactions. We report the case of a 28-year-old female who presented with generalized pustular psoriasis (Von Zumbush type). She was initially put on conventional modalities like methotrexate and retinoids, but on failing to respond to these agents and appearance of side effects, these drugs had to be stopped. Cyclosporin A was started in the dose of 3.5 mg/kg of bodyweight after performing the baseline investigations. Cyclosporin A is a potent selective immunosuppressant with a principal effect directed against cell-mediated immune response. A dramatic response was seen as lesions cleared rapidly within a week. The patient is now on a maintenance dose of 2.5 mg / kg bodyweight.

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