The Effect Of Cyclosporin In The Treatment Of Childhood Atopic Dermatitis

Lee, Si Won; Lee, Yong Suk; Lee, Seung Chul

Abstract

BACKGROUND: Atopic dermatitis is a chronic skin disease, most common in childhood. Severe atopic dermatitis may require the regular use of topical corticosteroids or systemic corticosteroids. These treatments are prone to several adverse side effects. Many studies have reported that short-term use of cyclosporin is a quite effective prescription for severe atopic dermatitis of adults. Unfortunately, there have been very few studies on the use of cyclosporin for children.
OBJECTIVE
The purpose of this study was to examine the effect of cyclosporin in treating severe atopic dermatitis of children. Mehtods: Thirteen children who had severe atopic dermatitis were treated with cyclosporin(Neoral , Norvatis). The dose of cyclosporin was 3mg/kg/day. The disease activity has been monitored on a weekly basis, based on changes in 6 parameters of sign; erythema, exudation, excoriation, dryness, cracking, and lichenification. We employed a measurement system in which six different sites(head and neck, hands, elbows, feet, legs, and trunk)were scored on 4 different scales; 0(none), 1(mild), 2(moderate), and 3(severe). In addition to parameters mentioned above, itching and sleep-disturbance were also monitored. These were assessed by patients or their parents in the same manner.
RESULTS
After 4 weeks of cyclosporin treatment, the significant reductions in mean severity scores and mean sysmptom scores were observed. The mean severity scores of 13 patients decreased from 42.0+/-13.3 to 14.0+/-13.1(p<0.01). The mean symptom scores of itching and sleep-disturbance decreased from 2.2+/-1.0, 2.1+/-1.0 to 0.8+/-1.0, 0.8+/-1.0(p<0.01), respectively. There were 6 events of adverse side effects throughout the study. Upper respiratory tract infection was the most frequent complication from 3 patients.
CONCLUSION
In view of these findings, we conclude that cyclosporin is effective in the treatment of severe atopic dermatitis of children without serious complications.