What is cyclosporin, and how is it used in the treatment of psoriasis?
MARK LEBWOHL, MD: Cyclosporin is a potent immunosuppressive agent commonly used to prevent acute transplant rejection. It is used only in severe cases of psoriasis, because it is associated with many side effects. And those patients treated with cyclosporin would have to have failed with safer treatments, such as phototherapy, or perhaps even methotrexate. If a patient tells me that they won’t give up their one or two beers a week, which is something we would not allow a methotrexate patient to have, I might consider them for cyclosporin. A woman who is pregnant and has severe psoriasis would be an ideal candidate for cyclosporin. It is one of the few treatments – aside from phototherapy and UVB phototherapy – that is not contraindicated during pregnancy. What are vitamin A derivatives, and are they effective? MARK LEBWOHL, MD: These are called retinoids. The one that is approved for psoriasis currently is acitretin, and there are certainly others on the horizon. They are very effectiv
