 |
|
Cyclosporine in the Treatment of Palmoplantar PustulosisA Randomized, Double-blind, Placebo-Controlled Study
Sakari Reitamo, MD, PhD;
Pekka Erkko, MD;
Anita Remitz, MD, PhD;
Antti I. Lauerma, MD, PhD;
Outi Montonen, MD;
Kari Harjula, MSc
Arch Dermatol. 1993;129(10):1273-1279.
Abstract
Background and Design
Palmoplantar pustulosis (PPP) is an inflammatory skin disease characterized by pustule formation, erythema, induration, and scaling of the affected skin of the palms and soles. Palmoplantar pustulosis is usually resistant to treatment. In a double-blind study (phase 1) of 4 weeks, 40 patients with PPP were randomized to receive oral cyclosporine, 2.5 mg/kg per day, or placebo. An open-label dose-finding phase 2 with cyclosporine doses of 1.25, 2.5, and 3.75 mg/kg per day was performed in the following 3 months. The patients were then followed for at least 2 months after termination of cyclosporine treatment. Response to treatment was judged by the number of fresh pustules. Patients displaying a reduction of 50% or greater in the number of pustules, compared with baseline, were defined as responders.
Results
Of the patients who completed phase 1, 17 of 19 patients in the cyclosporine group and four of 15 in the placebo group were classified as responders (P<.001). Cyclosporine, but not placebo, significantly reduced formation of new pustules (P=.001). In the subsequent open phase, a daily cyclosporine dose of 1.25 mg/kg appeared to be an effective treatment of PPP in approximately half of the treated patients. Many patients relapsed after initial success with cyclosporine. However, only one patient studied totally failed to respond to cyclosporine treatment. At the end of phase 3, most of the studied parameters had returned to pretreatment levels. The most common side effect was headache in the 2.5 mg/kg per day dosage group; no significant side effects were observed in the 1.25 mg/kg per day dosage group.
Conclusions
Low-dose cyclosporine treatment (1.25 to 2.5 mg/kg per day) is effective in PPP.
(Arch Dermatol. 1993;129:1273-1279)
Author Affiliations
From the Department of Dermatology, Helsinki (Finland) University Central Hospital (Drs Reitamo, Erkko, Remitz, Lauerma, and Montonen); and Sandoz Ltd, Helsinki (Mr Harjula).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
IL-8 as Antibody Therapeutic Target in Inflammatory Diseases: Reduction of Clinical Activity in Palmoplantar Pustulosis
Skov et al.
J. Immunol. 2008;181:669-679.
ABSTRACT
| FULL TEXT
Cigarette Smoking and Inflammatory Skin Disease: The Good and the Bad
Smith and Smith
Arch Dermatol 1997;133:901-902.
ABSTRACT
A 61-Year-Old Man With Psoriasis
Baughman
JAMA 1996;276:1421-1428.
ABSTRACT
Psoriatic Arthritis: New Types, New Treatments
Ruzicka
Arch Dermatol 1996;132:215-219.
ABSTRACT
Cyclosporine Effective for Treating Palmoplantar Pustulosis
Journal Watch Dermatology 1993;1993:3-3.
FULL TEXT
Psoriasis and Cigarettes: Another Nail in the Coffin
Baughman
Arch Dermatol 1993;129:1329-1330.
ABSTRACT
|
