Cyclosporin A in severe, therapy-resistant atopic dermatitis: report of an international workshop, April 1993.

Data on the use of oral cyclosporin A (CyA; Sandimmun) therapy for severe adult atopic dermatitis have accumulated since 1987. Details of over 200 adult patients who have received short-term CyA were presented at an international workshop in April 1993. Eighty-six of these patients had participated in three randomized, double-blind, placebo-controlled studies in which CyA was given for 6-8 weeks. The efficacy and safety of short-term CyA treatment in atopic dermatitis is established, provided that appropriate guidelines are observed. Evidence to date suggests that atopic dermatitis patients are no more prone to toxicity than patients with psoriasis, in whom more detailed and longer-term data are available. Early data also suggest that long-term CyA may be effective in atopic dermatitis, but there is concern regarding long-term safety, as experience is still limited. Careful monitoring of all CyA-treated patients is therefore mandatory. CyA should only be used under the direct and regular supervision of a hospital-based dermatologist who is knowledgeable in the use of cyclosporin A, and experienced in the management of severe skin disease and in the use of potentially toxic drugs.