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Low-dose cyclosporine A in the treatment of disabling morphea.

To the Editor.— Cyclosporine A is an immunosuppressive agent that has been used primarily in transplantation medicine. It has also been used in a variety of dermatologic diseases, including severe psoriasis vulgaris,1pyoderma gangrenosum,2granuloma anulare,3vitiligo,4Behcet's disease,5pemphigus vulgaris,6and alopecia areata.7In lupus erythematosus, its use has met with limited success (unpublished observations). Disabling morphea is a rare disease that is often resistant to most forms of treatment; intravenous administration of penicillin, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended.6 We describe two male patients, 50 and 40 years of age, respectively, who presented with severe, rapidly progressive disabling morphea, and who showed marked improvement on treatment with cyclosporine A, after treatment with NSAIDs, high-dose intravenous penicillin (both cases), diuretics, and high daily doses of methyl prednisolone (case 1 only) had been ineffective. Report of Cases.—Case 1.—