SUCCESSFUL MONOTHERAPY OF SEVERE AND INTRACTABLE ATOPIC-DERMATITIS BYPHOTOPHERESIS

Background: Patients with chronic atopic dermatitis can become unrespo nsive to standard immunosuppressive therapy and thus pose a serious th erapeutic problem. Objective: Our purpose was to evaluate the therapeu tic effectiveness of photopheresis in the management of patients with severe and intractable atopic dermatitis. Methods: Photopheresis was u sed as monotherapy in patients (n = 3) who previously did not respond to treatment with glucocorticosteroids, cyclosporine, phototherapy, or photochemotherapy. Patients were treated at 2-week intervals (total n umber of treatments = 10). Results: In all patients, photopheresis ind uced clinical improvement and reduction of elevated serum levels of eo sinophil cationic protein and total IgE. Prolongation of the intervals between treatments from 2 to 4 weeks caused worsening in one patient, whereas shortening of treatment-free intervals improved both clinical and laboratory findings. Conclusion: These studies indicate that phot opheresis may be used as monotherapy for the treatment of patients wit h severe atopic dermatitis that has become intractable to standard the rapeutic modalities.