Systemic treatment of severe psoriasis

Australasian Journal of Dermatology

Volumn 38, Issue 4, 1997, Pages 171-180

  Georgouras, Katherine E ^a,c   Zagarella, Samuel S ^b   Cains, Geoffrey D ^b   Brown, Pamela J ^a  

^a UNIVERSITY OF NEW SOUTH WALES   (Australia)

^b LIVERPOOL HOSPITAL   (Australia)

^c Visiting Medical Officer   (Australia)

Author keywords

Cyclosporin; Methotrexate; Phototherapy; Retinoids

Indexed keywords

ANTIPSORIASIS AGENT; BERGAPTEN; CYCLIC AMP; CYCLOSPORIN; CYCLOSPORIN A; ETRETIN; ETRETINATE; GAMMA INTERFERON; INTERCELLULAR ADHESION MOLECULE 1; INTERLEUKIN 1; INTERLEUKIN 2; INTERLEUKIN 6; INTERLEUKIN 8; ISOTRETINOIN; METHOTREXATE; METHOXSALEN; RETINOID DERIVATIVE; TUMOR NECROSIS FACTOR ALPHA;

CLINICAL TRIAL; DISEASE SEVERITY; DRUG EFFICACY; DRUG SAFETY; HUMAN; HYPERTENSION; IMMUNE DEFICIENCY; IMMUNOSUPPRESSIVE TREATMENT; MALAISE; NAUSEA; NEPHROTOXICITY; NEUTROPENIA; ORAL DRUG ADMINISTRATION; PHOTOTHERAPY; PREGNANCY; PSORIASIS; PUVA; REVIEW; TREATMENT CONTRAINDICATION; TREATMENT INDICATION; VOMITING;

EID: 0030778372     PISSN: 00048380     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1440-0960.1997.tb01690.x     Document Type: Review

References (112)

1. Hunter JAA, Savin JA, Dahl MV. Psoriasis. Clinical Dermatology; 2nd edn. Oxford: Blackwell Science, 1995; 51-G5.
2. Fritsch PO. Hetinoids in psoriasis and disorders of keratinization. J. Am. Acad. Dermatol. 1992; 27: S8-14.
3. Mangelsdorf DJ, Ong ES, Dyck JA, Evans RM. Nuclear receptor that identifies a novel retinoic acid pathway. Nature 1990; 345: 224-9.
4. Vahlquist A, Torma II. Retinoids and keratinization: Current concepts. Int. J. Dermatol 1988; 27:81-95.
5. Ball U, Hawkes JE, Ney UM, Westmacott D, Williams D. Effects of retinoids in an immune model of inflammation in mice Br. J. PharmacoL 1986; 89: 814.
6. Ellis CNS, Grekin RC, Lobuglio AF, Voorhees TT. Etretinate therapy for psoriasis. Arch. Dermatol. 1985; 121: 877-80.
7. Marconi M, Montagna D, Alberini G, Porta F, Lembo G, Giannetti A. In vivo and in vitro evaluation of the influence of aromatic retinoid Ro 10-9359 and of its metabolite Ro 10-1670 on polymorphonuclear leukocyte and lymphocyte functions in psoriatic subjects. Ada Derm. I'enereol Suppl 1984; 115:47-9.
8. Holian O, Kumar R. Cyclic AMP and cyclic AMP-dependent protein kinase in mouse skin. II. In vitro effects of isotretinoin and etretinate. Arch. Dermatol. Res. 1985; 278: 161-4.
9. Raynaud F, Leduc C, Anderson WB, Evain-Brion D. Retinoid treatment of human psoriatic fibroblasts induces an increase in cyclic AMP-dependent protein kinase activity. J. Invest. Dermatol. 1987; 89: 105-10.
10. Runne V, Orfanos CE, Gartmen II. Peroralc applikation 3 weir derivate der vitamin-A-saure 3 ur internen psoriasis-thérapie: 13-cis-beta vitamin-A-saure and vitamin-A-saure-aethylamid. Arch. Dermatol. Res. 1973; 247: 171-80.
11. Sofen II, Moy R, Lowe NJ. Treatment of generalised pustular psoriasis with Isolretinoin. Lancet 1984; 1: 40.
12. Lowe NJ, Lazarus V, Matt L. Systemic retinoid therapy for psoriasis. J. Am. Acad. Dermatol. 1988; 19: 186-91.
13. Wiegand U-W, Cunliffe W, Wyss R, Crevoisier C. TVeatment of female patients with isotretinoin: What is the safe post-therapy contraceptive period? In: Clinical Dermatology 2000, Vancouver, 28-31 May 1996. Abstract No. 155.
14. Brindley C. An overview of recent clinical pharmacokinetic studies with acitretin (RO 10-1670, etretin). Dermatologica 1989; 178: 79-87.
15. Rollman 0, Valquist A. Retinoid concentrations in skin, serum and adipose tissue of patients treated with etretinate. Br. J. Dermatol. 1983; 109: 439-47.
16. DiGiovanna JJ, Zech LA, Ruddel ME, Gantt G, Peck GL. Etretinate: persistent serum levels after long-term therapy. Arch. Dermatol. 1989; 125:246-51.
17. Larsen FG, Vahlquist C, Anderson E, Torma H, Kragballe K, Vahlquist A. Oral acitretin in psoriasis: Drug and vitamin A concentrations in plasma, skin and adipose tissue. Acta Derm. I'enereol. Suppl. 1992; 72: 84-8.
18. Orfanos CE. Retinoide: Der neue Stand. Erhaltungstherapie, Resorptionsstorungen bei 'non-responders.' Interaktionen und Interferenzen mit Medikamenten, Behandlung von Kindern und Knochentoxizitat, Acitretin und 13-dis-Acitretin. Hautarzt 1989; 40: 123-9.
19. Wolska H, Jahlonska S, Langner A, Fraczykowska M. Etretinate therapy in generalized pustular psoriasis (Zumbusch type): Immediate and long term results. Dermalologica 1985; 171: 297-304.
20. Löwe NL. When systemic retinoids fail to work in psoriasis. In: Saurat JII (ed). Retinoids: 10years. Basel: Karger, 1991; 341-9.
21. Berbis P, Geiger JM, Vaisse C, Rognin C, Privat Y. Benefit of progressively increasing doses during the initial treatment with acitretin in psoriasis. Dermatologica 1989; 178: 88-92.
22. Greaves MW, Weinstein GD. Treatment of psoriasis. N. Engl. J. Med. 1995; 352: 581-8.
23. Morison WL. Phototherapy and Photochemotherapy of Skin Diseases, 2nd edn. New York: Raven Press, 1991; 169-180.
24. Honig B, Morison WL, Karp D. Photochemotherapy beyond psoriasis. J. Am. Acad. Dermatol. 1994; 51: 775-90.
25. Gilmor JW, Vestey JP, Norval M. The effect of UV therapy on immune function in patients with psoriasis. Er. J. Dermatol 1993; 129:28-38.
26. Gilmor JW, Vestey JP, George S, Norval M. EfTcct of phototherapy and urocanic acid isomcrs on natural killer cell function. J. Invest. Dermatol. 1993; 101: 169-74.
27. Meola T, Soter NA, Ostreicher R, Sanchez M, Moy JA. The safety of UVB phototherapy in patients with HIV infection. J. Am. Acad. Dermatol. 1993; 29: 216-20.
28. Fotiades J, Lim IIW, Jiang SB, Soter NA, Sanchez M, Moy J. Efficacy of ultraviolet B phototherapy for psoriasis in patients infected with human immunodeficiency virus. Photodermatol. Photoimmunol. Photomed. 1995; 11: 107-11.
29. Nyfors A, Dahl-Nyfors B, Hopwood D. Liver hiopsies from patients with psoriasis related to photochemotherapy (PUVA): Findings before and after one year of therapy in 12 patients: A blind study and review of literature on hepatotoxicity of PUVA. J. Am. Acad. Dermatol. 1986; 14: 43-8.
30. Stern RS. Outcomes of pregnancies among women and partners of men with a history of exposure to methoxsalen photochemotherapy (PUVA) for the treatment of psoriasis. Arch. Dermatol 1991; 127:347-50.
31. Studniberg HM, Weller P. PUVA, UVB, psoriasis, and nonmelanoma skin cancer. J. Am. Acad. Dennalol 1993; 29:1013-22.
32. Stern S, Nichols KT, Vakeva LH. Malignant melanoma in patients treated for psoriasis with methoxsalen (psoralen) and ultraviolet A radiation (PUVA). A'. Engl. J. Med. 1997; 556: 1041-5.
33. Sakuntabhai A, Sharpe GR, Farr PM. Response of psoriasis to twice weekly PUVA. Br. J. Dermatol 1993; 128: 166-71.
34. Buckley D, Healy E, Rogers S. A comparison of twice-weekly MPD-PUVA and three times-weekly skin typing-PUVA regimens for the treatment of psoriasis. Br. J. Dermatol. 1995; 155: 417-422.
35. Rofol E, Hamilton T, Gonzales E. Comparison of minimal phototoxic dose and skin type for determining initial UVA dose in oral liquid melhoxsalen photochemotherapy for the treatment of psoriasis. J. Ini-est. Dermatol. 1991; 97: 1048-52.
36. Colzovara-Pinton P, Ortel B, CortinoA, Honigsmann II, DePonifils G. A reappraisal of the use of 5-methoxypsoralen in the therapy of psoriasis. Exp. Dennatol 1992; 1:46-51.
37. Löwe NJ, Weingarten D, Bouret T, Moy LS. PUVA therapy for psoriasis: Comparison of oral and bath-water delivery of 8methoxypsoralen. J. Am. Acad. Dermatol 1986; 14: 754-60.
38. Collins P, Rogers S. Bath-water delivery of 8-methoxypsoralen therapy for psoriasis. Clin. Exp. Dermatol 1991; 16: 165-7.
39. Gomoz MI, Azôna JM, Arronz I, Horto A, Ledo A. Plasma levels of 8-methoxypsoralen after bath-PUVA for psoriasis: Relationship to disease severity. Br. J. Dermatol. 1995; 155: 37-40.
40. Saurai JH, Geiger JM, Amibiard P et al Randomized double-blind miilticentre study comparing acitretin-PUVA, etretinate-PUVA, and placebo-PUVA in the treatment of severe psoriasis. Dennatologica 1988; 177: 218-24.
41. Weinstein GD, White GM. An approach to the treatment of moderate to severe psoriasis with rotational therapy. J. Am. Acad. Dennatol. 1993; 28: 454-9.
42. Storbeck K, Holzle E, Schurer N, Lehmann P, Plewig G. Narrowband UVB (311 nm) vs. conventional broad-band UVB with and without ditliranol in phototherapy for psoriasis. J. Am. Acad. Dennatol. 1993; 28: 227-31.
43. George JA, Bilsland DJ, Wainwright N'J, Ferguson J. Failure of coconut oil to accelerate psoriasis clearance in narrow-band UVB phototherapy or photochemotherapy. Br. J. Dennatol. 1993; 128: 301-5.
44. Hudson-Peacock MJ, Diffey BL, Farr PM. Photoprotective action of emollients in ultraviolet therapy of psoriasis. Br. J. Dermatol. 1994; 150:361-5.
45. Lebwohl M, Martinez J, Weber P, DeLuca R. Effects of topical preparations on the erythemogenicily of UVB: Implications for psoriasis phototherapy. J. Am. Acad. Dennatol. 1995; 52:469-71.
46. Gibbs NK, Norval M, Traynor NJ, Crosby JC, Löwe G, Johnson BE. Comparative potency of broad-band and narrow-band phototherapy sources to induce edema, sunburn cells and urocanic acid photoisomerizalion in hairless mouse skin. Pliotochem. Photobiol. 1993; 58: 643-7.
47. Gibbs NK, Traynor NJ, MacKic RM, Campbell I, Johnson BE, Ferguson J. The phototumorigenic potential of broadband (270-350 nm) and narrow-band (311-313 nm) phototherapy sources cannot be predicted by their edematogenic potential in hairless mouse skin. J. Invest. Dermatol. 1995; 104: 359-63.
48. Kerscher M, Volkenandt M, Plewig G, Lehman P. Combination phototherapy of psoriasis with calcipotriol and narrow-band UVB (Letter). Lancet 1993; 542: 923.
49. McKenna KE, Stern RS. Photosensitivity associated with combined UV-B and calcipotriene therapy. Arch. Dermatol. 1995; 151: 1305-7.
50. Physician's Desk Reference, 49th edn. 1995; 1165-9.
51. Calabresi P, Chabner BA. Antineoplastic agents. In: Goodman AG, Rail TW, Nies AS, Taylor P (eds). Goodman and Oilman's Tlie Pharmacological Basis of Tlierapeutics. New York: Pergamon Press, 1990; 1223-7.
52. Ahern MJ, Kevat S, Hill W, Hay ball PJ, Harley H, Hall P de la M. I lepatic methotrexate content and progression of hepatic fibrosis: Preliminary findings. Ann. Rheum. Dis. 1991; 50: 477-80.
53. Hall P de la M, Ahern MJ, Jarvis LR, Stoll P, Jenner MA, Harley II. Two methods of assessment of methotrexate hepatotoxicity in patients with rheumatoid arthritis Ann. Rheum. Dis. 1991; 50: 471-C.
54. Collins P, Rogers S. The efficacy of methotrexate in psoriasis: a review of 40 cases. Clin. Exp. Dermatol 1992; 17:257-GO.
55. Rumar B, Dhar S, Handa S, Kaur I. Methotrexate in childhood psoriasis. Pediatr. Dennatol. 1994; 11: 272-3.
56. Kugathasan S, Newman AJ, Dahms BB, Boyle JT. Liver biopsy findings in patients with juvenile rheumatoid arthritis receiving long-term, weekly methotrexate therapy. J.Pediatr. 1996; 128: 149-51.
57. Boffa MJ, Chalmers RJC, Haboubi NY, Shomaf M, Mitchell DM. Sequential liver biopsies during long-term methotrexate treatment for psoriasis: A reappraisal. Br. J. Dermatol 1995; 153: 774-8.
58. May-all B, Poggi G, Parkin JD. Neutropenia due to low-dose methotrexate therapy for psoriasis and rheumatoid arthritis may be fatal. Med. J. Aust. 1991; 155: 480-4.
59. Weinblatt ME, Trenlham DE, Fraser PA et al. Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis. Arthritis Rheum. 1988; 51: 167-75.
60. Casserly CM, Stange KG, Chren M-M. Severe megaloblastic anemia in a patient receiving low-dose methotrexate for psoriasis. J. Am, Acad. Dermalol 1993; 29: 477-80.
61. Roenigk IIH Jr, Auerback R, Mailbach HI, Weinstein GD. Methotrexate in psoriasis: Revised guidelines. J. Am, Acad. Dermatol. 1988 19:145-53.
62. Stenger AAME, Houtman PM, Brun GAW, Eggink HF, Pasma HR. Pneumocystis carinii pneumonia associated with low dose methotrexate treatment for rheumatoid arthiritis. Scand. J. Rheumatol 1993; 23: 51-3.
63. Hargreaves MR, Mowat AG, Benson MK. Acute pneumonitis associated with low dose methotrexate treatment for rheumatoid arthritis: Report of five cases and review of published report Tlwrax 1992; 47: 628-33.
64. Morris LF, Harrod MJ, Menter MA, Silverman AK. Methotrexate and reproduction in men: Case report and recommendations. J. Am. Acad. Dennatol. 1993; 29: 913-1G.
65. Coe RO, Bull FE. Cirrhosis associated with metholrexate treatment of psoriasis. JAMA 1968; 206: 1515-20.
66. O'Connor GT, Olmstead EM, Zug R et al. Detection of hepatotoxicily associated with methotrexate therapy for psoriasis. Arch. Dennatol 1989 123: 1209-17.
67. Nohlgârd C, Rubio CA, Kock Y, Hammar II. Liver fibrosis quantified by image analysis in methotrexate-treated patients with psoriasis. J. Am. Acad. Dermatol. 1993; 23:40-5.
68. Shergy WJ, Polisson RP, Caldwell DS, Rice JR, Pisetsky DS, Allen NB. Methotrexate-associated hepatotoxicity: Retrospective analysis of 210 patients with rheumatoid arthritis. Am. J. Med. 1988 85: 771-4.
69. Nyfors A, Poulsen H. Liver biopsies from psoriatics related to methotrexate therapy. Findings in 123 consecutive nonmethotrexate treated patients. Ada Pathol. Microbiol. Scand. [A] 1976;84:253-61.
70. Dolan OM, Burrows D, Irvine A, Walsh M. The value of a baseline liver biopsy prior to methotrexate treatment. Br. J. Dermatol. 1994; 151:891-4.
71. Zachariae H, Kragballe K, Soggard H. Methotrexate induced liver cirrhosis. Br. J. Dermatol 1980; 102:407-12.
72. Lanse SB, Arnold GL, Gowans JDC, Kaplan MM. Low incidence of hepatotoxicity associated with long-term low-dose oral methotrexate in treatment of refractory psoriasis, psoriatic arthritis and rheumatoid arthritis. An acceptable risk/benefit ratio. Dig. Dis. Sei. 1985; 50: 104-9.
73. Krcmer JM, Lee RG, Tolman KG. Liver histology in rheumatoid arthritis patients receiving long-term methotrexate therapy. Arthritis Rheum. 1989; 52: 121-7.
74. Kremer JM, Kaye GI, Kaye NW, Ishak KG, Axiotis CA. Light and electron microscopic anaylsis of sequential liver biopsy samples from rheumatoid arthritis patients receiving long-term methotrexate therapy. Arthritis Rheum. 1995; 38: 1194-1203.
75. Zachariae II, Soggard II. Methotrexate-induced liver cirrhosis: A follow-up. Dermatologica 1987; 175: 178-82.
76. Nyrfors A. Liver biopsies for psoriatics relating to methotrexate therapy. Findings in post methotrcxate liver biopsies from 160 psoriatics. Acta Pathol. Microbiol. Scand, [A] 1977; 85: 511-18.
77. Mitchell D, Johnson RJ, Testa IIJ, Haboubi NY, Chalmers RJG. Ultrasound and radionuclide scans: poor indicators of liver damage in patients treated with melhotrexate. Clin. Exp. Dermatol. 1987; 12: 243-245.
78. Coulsen IH, McKenzie J, Neild VS, Joseph AE, Marsden RA. A comparison of liver ultrasound with liver biopsy histology in psoriatics receiving long-term methotrexate therapy. Br. J. Dermatol 1987; 116:491-5.
79. Kremer JM, Alarcon GS, Lightfoot RW Jr et al. Methotrexate for rheumatoid arthritis: Suggested guidelines for monitoring liver toxicity. Arthritis Rheum. 1994; 37: 316-28.
80. Kremer JM, Phelps CT. Long-term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis: Update after a mean of 90 months. Arthritis Rheum. 1992; 55: 138-45.
81. Mueller W, Herrmann B. Cyclosporin A for psoriasis. N Engl. J. Med. 1979; 501: 555.
82. Borel J.F. Mechanism of action and rationale for cyclosporin A in psoriasis. Br. J. Dermatol. 1990; 122 (Suppl. 36): 5-12.
83. Griffiths GEM, Powles AV, Leonard JN, Fry L, Baker BS, Valdimarsson II. Clearance of psoriasis with low dose cyclosporin. Br. Med. J. (Clin. Bes. Ed.) 1986; 295: 731-2.
84. Ellis CN, Gorsulowsky DC, Hamilton TA et al. Cyclosporine improves psoriasis in a double-blind study. JAMA 1986; 256: 3110-16.
85. Van Joost TU, Heule F, Stolz E, Beukers R. Short term use of cyclosporin A in severe psoriasis. Br. J. Dennatol. 1986; 114: 615-20.
86. Picascia DD, Garden JM, Freinkel RK, Roenigk IIII Jr. Treatment of resistant severe psoriasis with systemic cyclosporin. J.Am. Acad. Dermatol. 1987; 17: 408-14.
87. Wentzell JM, Baughman RD, O'Connor GT, Bernier GH Jr. Cyclosporin in treatment of psoriasis, y/ncft. Umna/oi 1987; 125:163-65.
88. Gupta AK, Brown MD, Ellis CN et al Cyclosporin in dermatology. J. Am. Acad. Dennatol. 1989; 21: 1245-56.
89. Van Joost TH, Bos JD, Heule F, Meinardi MM. Low-dose cyclosporin A in severe psoriasis: A double-blind study. Br. J. Dermatol 1988; 118: 183-90.
90. Italian Multicentre Study Group on Cyclosporin in Psoriasis. Cyclosporin vs. ctretinate: Italian multicentre comparative trial in severe plaque-form psoriasis. Dermatology 1993 187 (Suppl. 1): 8-18.
91. Finzi AF, Mozzanica N, Caltaneo A, Chiappino G, Pigatto PD. ElTcctiveness of cyclosporin treatment in severe psoriasis: A clinical and immune-logical studyJ. Am. Acatl Dermatol 1989; 21: 91-7.
92. Dubertret L, Perussel M, Robioca 0, Feutren, G. Cyclosporin in psoriasis: A long-term randomised study on 37 patients. Acta Denn. Venereal Suppl. 1989; 146: 136.
93. Ellis CN, Fradin MS, Messana JM et al. Cyclosporin for plaquetype psoriasis: Results of multidose, double-blind trial. A'. Engl. J.Med. 1991; 524: 277-84.
94. Griffiths GEM, Powles AV, McFadden J, Baker BS, Valdimarsson H, Fry L. Long-term cyclosporin for psoriasis. J. Dermatol. 1989; 120: 253-60.
95. Mahrle G, Schulze IIJ, Faerber L, Weidinger G, Steigledger GK. Low-dose short term cyclosporin vs. etretinate in psoriasis: Improvement of skin, nail and joint involvement J. Am. Acad. Dermatol. 1995; 52: 78-88.
96. Lewis HM, Powles AV, Thomas E et al. Cyclosporin A in the treatment of chronic plaque psoriasis: Six year experience. J. Dermatol. Treatment 1993; 4: 3-7.
97. Timonen P, Friend D, Abeywickrama K, Laburte C, von Graffenried B, Feutren G. Efficacy of low-dose cyclosporin A in psoriasis: Results of dose-finding studies. Br. J. Dermatol. 1990; 122 (Suppl. 36): 33-40.
98. Reitamo S, Erkko P, Remitz A, Lauerma AI, Montonen 0, Hnrjula K. Cyclosporine in the treatment of palmoplantar pustulosis. Arch. Dermatol. 1993; 129: 1273-9.
99. Faulds D, Goa KL, Benfield P. Cyclosporin: A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in immunoregulatory disorders. Drugs 1993; 45: 953-1040.
100. Fingi AF. Individualised short-course cyclosporin therapy in psoriasis. Br. J. Dermatol. 1996; 135 (Suppl. 48): 31-4.
101. Berth-Jones J. Clinical aspects: Preliminary experience with a novel oral formulation of cyclosporin (Neoral). Br. J. Dermatol. 1996; 155 (Suppl. 48): 5-8.
102. Beveridge T, Gratwohl A, Michot F et al. Cyclosporin A: Pharmocokinetics after a single dose in man and serum levels after multiple dosing in recipients of allogenic bone marrow grafts. Curr. Ther. Res. 1981; 50: 5-18.
103. Smith S.G. Neoral (cyclosporin) in dermatology: Technical aspects. Br. J. Dermatol 1996; 135 (Suppl. 48): 2-4.
104. Holt DW, Mueller EA, Kovarik JM, van Bree JB, Richard F, Kutz K. The pharmacokinetics of Sandimmun, Neoral: A new oral formulation of cyclosporin. Transplant. Proc. 1994; 26: 2935-9.
105. Krupp P, Monka C. Side effect profile of cyclosporin A in patients treated for psoriasis. Br.J. Dermatol. 1990; 122 (Suppl. 36): 47-56.
106. London NJ, Farmer)' SM, Wilt EJ, Davison AM, Lodge JPA. Risk of neoplasia in renal transplant patients. Lancet 1995; 546:403-6.
107. Iliesse C, Larue JR, Kriaa P et al Incidence and type of malignancies occurring after renal transplantation in conventionally and in cyclosporine-treated recipients: Single-center analysis of a 20-year period in 1600 patients. Transplant. Proc. 1995; 27: 2450-1.
108. Chuang FR, Hsieh II, Hsu KT, Huang HF. Increasing transplant cancer patient survival by conversion of immunosuppressive agents. Transplant. Proc. 1996; 28: 1346-7.
109. Mihatsch MJ, Belghiti D, Bohman SO et al. Kidney biopsies in control of cyclosporin A-trcated psoriatic patients: International kidney biopsy registry of cyclosporin A (Sandimmun) in autoimmune diseases. Br. J. Dermatol. 1990; 122 (Suppl. 36): 95-100.
110. Yee GC, Lennon TP, Gmur DJ, Kennedy MS, Deeg IIJ. Agedependent cyclosporine pharmacokinetics in marrow transplant recipents. Clin. Pharmacol Ther. 1986; 40: 438-43.
111. Zaki I, Emerson R, Allen BR. Treatment of severe atopic dermatitis in childhood with cyclosporin. Br. J. Dermatol 1996; 155 (Suppl. 48): 21-4.
112. Weber J, Galpin S. Cyclosporin A (Letter and Response). Nature 1995; 575: 198.