The use of combination oral therapies in the management of severe psoriasis
is gaining increasing acceptance. We report the concurrent use of mycophen
olate mofetil (MMF) (maximum dose 3.0 g daily) with low-dose cyclosporin (m
ean dose 2.5 mg/kg/day) in nine patients with severe psoriasis. All had pre
viously failed on other systemic therapies. They were all initially on trea
tment with cyclosporin alone which had either failed to clear their psorias
is or they were unable to tolerate higher doses. After the addition of MMF
there was good clinical improvement in three patients and moderate disease
control in a further four patients after a follow-up period of 3-11 months,
with no additional evidence of toxicity at the doses used. We believe that
MMF may be useful in some psoriatic patients unresponsive to or intolerant
of other treatments or who are at risk of developing nephrotoxicity at hig
her doses of cyclosporin.