Cyclosporine is a cyclic undecapeptide of fungal origin that forms the cornerstone of therapy for maintenance psoriasis. However, blood concentrations of cyclosporine must be maintained within a relatively narrow range to achieve effectiveness with a minimum of nephrotoxic effects. Recently, Yee et al1 suggested that grapefruit juice could be used to save costs by reducing the dose of cyclosporine. We tried to use grapefruit juice to increase blood concentrations of cyclosporine, not to reduce the dose or cost of cyclosporine, and managed successfully 2 cases of severe psoriasis.
Report of Cases. Case 1.
Generalized psoriasis developed in a 57-year-old man with a 10-year history of localized psoriasis. The patient had large infiltrated scaly plaques on his trunk and extremities. Previous treatment included topical and systemic steroids, retinoids, and oral psoralen with UV-A therapy. Despite treatment, the lesions progressed. He was then started on therapy with cyclosporine (5 mg/kg daily).
Taniguchi S, Kobayashi H, Ishii M. Treatment of Psoriasis by Cyclosporine and Grapefruit Juice. Arch Dermatol. 1996;132(10):1249. doi:10.1001/archderm.1996.03890340115024