DELAYED-TYPE HYPERSENSITIVITY IN PALMOPLANTAR PUSTULOSIS - EFFECT OF CYCLOSPORINE-A TREATMENT ON SKIN TESTING WITH RECALL ANTIGENS

Delayed-type hypersensitivity reactions to skin antigens are an indire ct measure of cellular immune response. We studied in a doable-blind m anner whether clinically effective doses of cyclosporin A in palmoplan tar pustulosis would diminish delayed-type hypersensitivity reactions in vivo, For testing delayed-type hypersensitivity, we applied intrade rmally a standardized panel of seven recall antigens and a vehicle con trol in 30 patients with palmoplantar pustulosis, and 28 were tested b oth at baseline and after 4 weeks. For 4 weeks 14 patients were treate d with 2.5 mg/kg/day cyclosporin A and 14 patients with placebo, Cyclo sporin A but not placebo caused a significant decrease in clinical dis ease parameters, In contrast, no significant differences in delayed-ty pe hypersensitivity reactions between treatment groups mere observed. The results do not support the view that the efficacy of low-dose cycl osporin A in dermatological disorders can be entirely explained by cyc losporin A's inhibitory actions an effector T-cells.