[Topical cyclosporine in the treatment of oral pemphigus]

Pemphigus vulgaris presents the typical blistering lesions at the level of oral mucosa in nearly all patients. The main drugs used in the treatment of the disease are steroids and immunosuppressive agents. Among the latter, cyclosporine A plays a pivotal role.

In this study the effects of topical cyclosporine have been evaluated in 12 patients (4 males and 8 females, mean age 65 years) suffering from oral pemphigus for at least 4 years non responsive to the previous treatments. Five ml of oral suspension (500 mg) were divided into three times a day; cyclosporine had to be kept in the oral cavity for 15 mins and no food nor drinks were allowed for 30 mins before and after the oral wash. The treatment lasted for 2 months.

At the end of the study a significant beneficial effect on erythema, oral lesions and pain was noticed. No side effects have been reported and the monitoring of full blood count, of renal and hepatic function and of blood pressure has not shown any variation from the baseline. Serum cyclosporine level has always been undetectable.

These encouraging results in the treatment of oral pemphigus need to be confirmed in controlled studies.