Cyclosporine Therapy for Bullous Erythema Multiforme

The document described the successful treatment of a 23-year-old woman with severe bullous erythema multiforme using cyclosporine. Initial treatments with systemic corticosteroids, acyclovir, dapsone, and cyclophosphamide were only partially effective. Cyclosporine, administered at an initial dose of 10 mg/kg per day and later adjusted to 5 mg/kg per day, resulted in the resolution of her skin lesions within a week. After discontinuing therapy for 3 months, the patient experienced a flare-up, but a second course of cyclosporine at 5 mg/kg per day cleared her skin again over 3 weeks. She remained free of recurrences for over a year and a half post-treatment. The case highlighted cyclosporine's potential as an effective treatment for dermatological conditions resistant to standard therapies, but also noted the importance of monitoring serum trough levels and the risk of nephrotoxicity requiring dosage adjustments.