Juvenile generalized circinate pustular psoriasis treated with oral cyclosporin A

We report on a 17-year-old boy presenting with relapsing generalized circinate pustular psoriasis exacerbated by streptococcal angina. Because of the severe course in his case, we started systemic treatment with cyclosporin A and corticosteroids. Corticosteroids could easily be tapered down. Cyclosporin A maintenance therapy was realized with 100 mg/day (1.6 mg per kg body weight and day). Side effects were a temporary increase in blood pressure during initiation with 200 mg cyclosporin A/day. After dose reduction no side effects were seen. The pustular lesions disappeared and the PASI score decreased from 40.7 to 4.8. The treatment was found to be well tolerated and effective.