Cyclical immunotherapy in patients with psoriasis

Psoriasis, a chronic and unpredictable dermatosis, is a constant therapeutical challenge to dermatologists. However, new knowledge in immunodermatology has stimulated interest in and encourage the use of new molecules, especially cyclosporin A (CyA). Thanks to certain characteristics, this molecule is capable of modulating and blocking the intense network of cytochine that seems to cause this dermatosis. The first clinical experiments have demonstrated that low dosages (3-5/kg die) can achieve rapid and effective remissions. The Italian experience gathered from numerous centres has been assessed to better understand and manage the use of CyA, especially as regards to tolerance and reliability. There is proven remission in 77% of the cases of plaque psoriasis. The duration of remission, as well as the paucity of side effects, has brought to the concept of cyclical therapy with CyA. The advantages of this mode of therapy are: the possibility of determining the most effective dosage; quantification of the dermatosis-free period; opportunity to personalize treatment and decide its duration; early intervention, should the dermatosis recur; exclusion of side effects and better control over those remaining.