ABSTRACT
Introduction The efficacy of cyclosporine in the treatment of psoriasis is well established. However widespread use of it has been limited by concerns over adverse effects such as hypertension, renal impairment and the potential risk of malignancy. The aim of this study is to determine the profile of our local psoriasis patients treated with cyclosporine, their response to treatment, their tolerability and the side-effects experienced. Materials and Methods This is a retrospective study of all psoriasis patients treated with cyclosporine for more than one month from January 1996 to June 2007 at the Department of Dermatology Ipoh Hospital. Results There were a total 21 patients, 8 males and 13 females. Their mean age was 40 years. There were 7 Malays, 10 Chinese and 4 Indians. Cyclosporine was given as the second or third line of treatment. The average starting dose was 2.76mg/kg and maximum dose was 3.89mg/kg. Best response was noted after 3 months of treatment. Thirteen (61.9%) patients had excellent response, 4(19%) had good response, 3 (14.3%) had moderate response and 1(4.8%) had poor response. Thirteen (61.9%) patients developed raised serum creatinine level exceeding 30% of the baseline while on treatment but all of them improved when the dosages of cyclosporine were reduced. None of them developed renal failure. There were 5 patients who had hypertension while on cyclosporine therapy, 2 of them required antihypertensive agents while for the remaining 3, blood pressure normalized after dosage reduction. Other side effects reported include gastrointestinal upset, gum hypertrophy and hypertrichosis. Conclusion Cyclosporine is effective in the treatment of psoriasis but close monitoring of serum creatinine and blood pressure is needed.