Changes

In most cases, anti-inflammatory drugs are required in addition to topical treatments and allergen-specific therapy to control residual pruritus and inflammation. The dose and treatment regime should be adapted according to how successful other treatments are, the response to treatment and the presence of allergen in the environment (for example, pollen is present in the summer but not the winter). The aim should be to use the minimum dose that gives effective control of pruritus.

In most cases, anti-inflammatory drugs are required in addition to topical treatments and allergen-specific therapy to control residual pruritus and inflammation. The dose and treatment regime should be adapted according to how successful other treatments are, the response to treatment and the presence of allergen in the environment (for example, pollen is present in the summer but not the winter). The aim should be to use the minimum dose that gives effective control of pruritus.

Cyclosporine is an immunosuppressive drug that acts by suppressing T-cells, as well as mast cells and eosinophils. The doses used in atopy are immuno-modulating, and suppression of these cells impairs antigen presentation, IgE production and the development of inflammatory lesions.⁴. Studies have suggested that cyclosporine is at least as effective as prednisolone for controllin atopic dermatitis⁴, but is better tolerated than the corticosteroid.

Cyclosporine is an immunosuppressive drug that acts by suppressing T-cells, as well as mast cells and eosinophils. The doses used in atopy are immuno-modulating, and suppression of these cells impairs antigen presentation, IgE production and the development of inflammatory lesions.⁴. Studies have suggested that cyclosporine is at least as effective as prednisolone for controllin atopic dermatitis⁴, but is better tolerated than the corticosteroid. The most likely side effects are transient anorexia and vomiting, but this can be avoided by administering cyclosporine with food. Uncommonly, hirsutism, alopecia, ginvival hyperplasia, diarrhoea, tremors or erythema of the ears may be seen, but these effects are dose-dependent and reversible⁴.

 

Immunosuppression is a potential concern.

 

Transient anorexia and vomiting are the most likely

problems. Persistent vomiting is uncommon but

may be eased by administering with food, and/or by

uncommon adverse effects include hirsuitism,

increased shedding of hair and transient alopecia,

gingival hyperplasia, papillomatosis, diarrhea,

lameness and muscle tremors, and erythema

and edema of the ears. These are largely dosedependent

and reversible. The nephropathy,

>20 mg/kg. Immunosuppression is a potential concern.

Inhibition of cell-mediated immunity in particular

Inhibition of cell-mediated immunity in particular

could result in bacterial and protozoal infections,

could result in bacterial and protozoal infections,