{'fraction_non_alphanumeric': 0.01767388825541619, 'fraction_numerical': 0.005701254275940707, 'mean_word_length': 4.754098360655738, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A sandfly in Surrey? A case of cutaneous leishmaniasis in the United Kingdom without history of recent travel to an endemic area

control of his HS. Hence ciclosporin was prescribed at 3 mg ⁄ kg daily, again with appropriate monitoring. Within 8 weeks he was weaned off prednisolone, as there was a marked clinical response in the HS and the residual acne had cleared completely. Ciclosporin was well-tolerated and was discontinued after 4 months in view of good disease control. The patient remained in remission for 4 months and the subsequent relapse was much milder than the pretreatment disease. The patient then elected to recommence ciclosporin, and had a further rapid response. The use of ciclosporin in HS has only been reported on two previous occasions. Gupta et al. treated a 60-year-old man with 6 mg ⁄ kg daily for 6 weeks and described a moderate response. Buckley and Rogers reported the successful use of ciclosporin 4.5 mg ⁄ kg daily in the treatment of pyoderma gangrenosum associated with HS, both of which responded fully. HS is a chronic suppurative disorder, the pathology of which is not fully understood and so it is difficult to know exactly how the calcineurin inhibitor ciclosporin is taking effect. However, ciclosporin is used in the treatment of a number of inflammatory dermatoses, and its ability to suppress cytokine production and T-cell activation is likely to explain the response reported here. It is possible that in these patients the condition remitted as a delayed effect of other treatments but this is unlikely. We believe that these cases illustrate an effective treatment option in this often intractable disease, though obviously randomised controlled trials to evaluate efficacy and safety would be ideal.