Severe chronic actinic dermatitis treated with ciclosporine: 2 cases

Introduction. The treatment of the severe forms of photodermatoses often re quires potent systemic immunosuppressive drugs. We report two patients suff ering from severe photodermatitis successfully treated with oral ciclospori ne, Cases report, A 58-year-old man developed severe pruritic eczematous reacti ons for several years on light-exposed and light-protected skin following e ach sun exposure. A 66-year-old man showed similar lesions restricted to th e head and neck. The clinical presentation and evolution as well as histolo gic, immunohistologic, allergologic and photobiologic assessments suggested the diagnosis of actinic reticuloid and persistent light reactivity, respe ctively. The lesions of both patients did not respond to a high dose regime n of systemic corticosteroids (methylprednisolone 1 mg/kg/day) for several weeks. The severity of cutaneous lesions and pruritus required another pote nt immunosuppressive treatment. Oral ciclosporine at the maximum daily dose of 4 mg/kg was given for three months. A rapid improvement of the pruritus and skin lesions occurred in the two patients, without significant side-ef fect. The first patient experienced reccurrent lesions after termination of cyclosporine treatment during summer time. The other patient did not devel op new skin eruption for 3 years after stopping the initial treatment with ciclosporine. Discussion, Low-dose oral cyclosporine is a quick-acting and well tolerated symptomatic treatment of severe photodermatoses resistant to other systemi c immunosuppressive drugs. However, therapeutic results do not consistently exhibit long-standing remanent effect.