Cyclosporin A in the Treatment of Lichen Planus

To the Editor.—  Cyclosporin A has now been successfully used in a variety of inflammatory dermatoses,^1-3 although the mechanism of action remains obscure and may not be related to the drug's potent immunosuppressive properties. Lichen planus (LP) is a disease that is characterized by a predominantly T-cell inflammatory infiltrate,4 and, whether cyclosporin A acts via its selective inhibition of T-lymphocyte proliferation⁵ or by some other as yet unknown mechanism, it seemed appropriate to assess the response of patients with LP to cyclosporin A.Eight patients (six men, two women; age range, 35 to 63 years) with widespread histologically proven LP (mean duration, 4.47 years [SEM ± 2.2]) were treated with oral cyclosporin A, 5 mg/kg per day. All patients were normotensive with normal serum creatinine levels prior to treatment. No concurrent topical therapy was used. Patients were seen at 2-week intervals for full clinical assessment, whole-blood cyclosporin level (12