Atopic dermatitis, cyclosporine, and nephrotoxicity

Abstract

noabstract: letter Dear Editor, Cyclosporine has been covered for the treatment for atopic dermatitis (AD) by the health insurance program in Japan since October 2008 [1]. Considering the fact that AD is one of the most common skin disorders, the number of AD patients with cyclosporine nephrotoxicity may increase in the future despite the lack of embrace of cyclosporine use by a substantial percentage of the dermatology community [1-3], although the prompt recognition of the disease may not be straight forward. Here, we present our experience with such a case in a 26-year-old male Crohn's disease (CD) patient complicated with AD. He was diagnosed with CD in 2009, when he developed several perianal fistulas requiring surgical drainage and was treated with oral mesalazine (2250 mg/day). At the end of March 2010, infliximab (5 mg/kg) in alternate months was added to his therapeutic regimen due to incomplete control of the disease activity. Thereafter, his clinical remission was maintained; however, he was referred to our hospital at the beginning of August 2012 due to a 5-month history of a moderate decline in his renal function, with a serum creatinine (sCr) level ranging from 1.5 to 2.0 mg/dL