Can cyclosporin A induce permanent remission of atopic dermatitis?

Three adult patients, who had suffered from severe therapy-resistant atopic dermatitis since childhood, were treated with long-term (29, 44 and 22 months) low-dose (maintenance dose: 0.5-0.7 mg/kg) cyclosporin A (CyA). All responded rapidly within 3-5 weeks and exhibited only minor exacerbations during the first phases of therapy. No relapse occurred in any of the patients after drug withdrawal. All patients remained symptom-free, except for occasional very mild and easily manageable localized lesions, for follow-up periods of 34, 13 and 22 months. Side-effects were minimal or tolerable (mild hypertrichosis in two patients, a slight decrease of creatinine clearance in one). In contrast with the clinical improvement, all atopy-related parameters such as blood eosinophilia, elevated IgE levels and specific IgE (RAST) reactivity remained essentially unchanged, as were skin dryness and stigmata of atopy. It is concluded that long-term low-dose CyA treatment may lead to permanent or long-term total or subtotal remission of atopic dermatitis.