A Clinical Experience of Cyclosporin A in Severe Atopic Dermatitis of Children

Ko, Eunyoung; Lim, Daehyun; Kim, Junghee; Son, Byongkwan

Abstract

PURPOSE
Severe atopic dermatitis is a condition that can seriously affect the quality of life. This study was performed to evaluate the efficacy and side effect of cyclosporin A treatment in children.
METHODS
Nine children(male 7, female 2) with severe atopic dermatitis resistant to conventional therapy and/or significant suffering and disability. The initial dose of cyclosporin A was 2.1-5.2 mg/kg/day and the duration of treatment was 4-6 weeks. The severity and extent of atopic dermatitis were evaluated with modified criteria of Hanifin and Rajka, at 0, 2, 4 and 6th week and after cessation of cyclosporin, at 10th week. Total clinical score was calculated as the average of both extent and severity score.
RESULTS
There are significant improvement in both of the symptom severity and the extent of atopic dermatitis. The mean severity and extent scores were 92% and 88% before treatment and 28% and 34% after 6 weeks' treatment. The overall change of the total clinical score was 59% of decrease. Two patients had to stop the drug after 4 weeks of treatment because of severe abdominal pain, especially at night. After stopping the drug, at the 10th weeks' evaluation, 3 patients showed symptomatic exacervations but 6 patients maintain their improved state only with conventional treatment.
CONCLUSION
: Despite the side effect, cyclosporin A gave a rapid clinical response to severe refractory atopic dermatitis in children.