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Updated: Mar 13, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Systemic cyclosporine treatment in severe childhood psoriasis: A retrospective chart review
Sunil Dogra1, Rahul Mahajan1, Tarun Narang1
1a Department of Dermatology , Venereology, and Leprology, Postgraduate Institute of Medical Education and Research , Chandigarh , India.
Insights
Systemic cyclosporine (CYC) is effective for severe childhood psoriasis, offering rapid disease control with mild side effects. This treatment shows promise for managing critical cases in pediatric patients under expert care.
Area of Science:
- Pediatric Dermatology
- Immunosuppressive Therapy
Background:
- Limited data exists on cyclosporine (CYC) use for pediatric psoriasis.
- Childhood psoriasis requires effective and safe treatment options.
Purpose of the Study:
- To evaluate the efficacy and safety of systemic cyclosporine in children with severe psoriasis.
- To assess treatment response and identify adverse events.
Main Methods:
- Retrospective review of pediatric psoriasis patients (<18 years) treated with systemic CYC.
- Clinical assessment of disease severity and response (PASI scores).
- Monitoring for CYC-induced toxicity through laboratory tests.
Main Results:
- Ten pediatric patients with severe psoriasis (plaque, erythroderma, pustular) received CYC.
- Excellent response (>75% PASI decrease) observed in most patients.
- Mean time to 50% PASI reduction was 4.2 weeks; mild side effects (abdominal pain, elevated creatinine) occurred in two patients.
Conclusions:
- Systemic cyclosporine is an effective crisis management therapy for severe childhood psoriasis.
- Treatment demonstrates a favorable safety profile with appropriate monitoring.
- CYC offers a viable option for severe pediatric psoriasis cases under expert supervision.
Background:
Data regarding the use of cyclosporine (CYC) in the treatment of childhood psoriasis is meager.
Materials And Methods:
The records of all psoriasis patients aged less than 18 years and treated with systemic CYC at our institute were retrieved. Clinical status of patients was assessed at regular intervals and response to therapy was graded as good (50-75% decrease in PASI) and excellent (>75% decrease). Laboratory investigations to detect CYC-induced toxicity were done at regular intervals.
Results:
There were total 10 children having psoriasis treated with systemic CYC over this period. Indication for the institution of CYC therapy was severe diseases, viz. extensive recalcitrant plaque type psoriasis in four patients, erythroderma in three and generalized pustular psoriasis in one patient. Response to therapy was excellent (>75% decrease in PASI) in all but three patients with psoriatic erythroderma. The mean time to control the disease, i.e. 50% reduction in PASI was 4.2 weeks. Side effects were mild, observed in two children, which included pain abdomen and an increase in serum creatinine over baseline value.
Conclusions:
CYC is an effective and reasonably safe drug to be used as crisis management therapy in severe childhood psoriasis under an expert supervision and laboratory monitoring.
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