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S. Wahie, S.J. Meggitt, Myotoxicity occurring with ciclosporin in a patient with atopic dermatitis, British Journal of Dermatology, Volume 153, Issue 6, 1 December 2005, Page 1238, https://doi.org/10.1111/j.1365-2133.2005.06980.x
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Conflicts of interest: None declared.
Sir, A 37‐year‐old Anglo‐Caribbean male, with a history of severe atopic dermatitis and asthma, was considered for ciclosporin therapy. Previous treatments such as phototherapy, topical tacrolimus and azathioprine (up to 3 mg kg−1 daily) had failed to control his disease. He was taking sertraline (50 mg daily) for depression. He was on no other medications and had no other medical problems. He did not drink alcohol.
His baseline glomerular filtration rate was 114 mL min−1 and full blood count, serum electrolytes, liver function tests, urate and lipid profile were all normal. Ciclosporin was commenced at a dose of 3 mg kg−1 daily. His disease activity quickly responded with a Six Area Six Sign Atopic Dermatitis score reduction from 30 to 12 within 4 weeks of treatment. However, 2 weeks after starting therapy, he began to describe intermittent muscular cramps in his upper limbs and around his paravertebral regions. Unfortunately, the improvement in his atopic dermatitis was not sustained and his ciclosporin dose was increased to 4 mg kg−1 daily.
