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Short-contact anthralin treatment augments therapeutic efficacy of cyclosporine in psoriasis: A clinical and pathologic study

1995; Elsevier BV; Volume: 33; Issue: 4 Linguagem: Inglês

10.1016/0190-9622(95)91286-x

1097-6787

Scott Gottlieb, Noah S Heftler, Patricia Gilleaudeau, Ray A. Johnson, V P Vallat, Jonathan Wolfe, Alice B. Gottlieb, James G. Krueger,

Nail Diseases and Treatments

Background: Psoriasis is characterized by immune activation and increased epidermal proliferation. Cyclosporine acts by reducing T lymphocyte numbers and lymphokine production. Anthralin inhibits keratinocyte proliferation. Objective: We investigated whether topical anthralin would augment clearing of psoriasis produced by systemic cyclosporine. Methods: Twelve patients with psoriasis were treated with cyclosporine (5 mg/kg per day). Patients applied anthralin only to plaques on half of their body. They were treated until a remission or maximum benefit was achieved. Disease activity was assessed by a severity index and quantitative histopathologic markers. Results: Of the 12 patients, the skin of five cleared within 10 weeks irrespective of anthralin use. The other seven (slow responders) continued treatment for a mean of 18 weeks. Slow responders had a significantly lower severity index, a thinner epidermis, fewer CD8+ cells, and fewer proliferating keratinocytes on the anthralin-treated side than on the non-anthralin-treated side. Conclusion: The combination of cyclosporine and topical anthralin is effective in patients who are slow to respond to cyclosporine alone.