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Bullous pemphigoid and psoriasis: Treatment with cyclosporine

1991; Elsevier BV; Volume: 24; Issue: 1 Linguagem: Inglês

10.1016/s0190-9622(08)80058-8

1097-6787

J.P. Boixeda, C. Soria, Susana Medina, Ana da Silva Lédo,

Dermatology and Skin Diseases

Bullous pemphigoid and psoriasis: Treatment with rTo the Editor: We read with interest the brief communication by Hisler et at.(J AM ACAD DEI~MATOL 1989;20:683-4) regarding a patient with a 50-year history of psoriasis in whom bulious pemphigoid developed after several forms of therapy.The patient was treated with erythromycin, tetracycline, niacinamide, and topical steroids without improvement.Finally, his treatment was switched to dapsone, 100 mg/day orally, to which he responded well.We have seen recently two patients, a 78-year-old man and a 66-year-old woman, both with a long history of psoriasis, in whom bullous pemphigoid developed.They did not respond well to topical steroids, and we treated them with cyclosporine, 5 mg/kg orally daily; the blisters and the psoriatic lesions cleared in 4 to 6 weeks.Treatment of bullous pemphigoid with psoriasis I presents a difficult problem because most physical modalities and topical agents that are effective for psoriasis may indupe bullous lesions.Furthermore, systemic steroids used in the treatment of bullous pcmphigoid might cause a flare of the psoriasis or pustular psoriasis after discontinuation.Cyclosporine is an aRernative therapy for these OaSeS.