ABSTRACT
The evidence of psoriasis as an immune-mediated disease can be traced back to 1979, when cyclosporine was first used in kidney transplant patients to prevent graft rejection. Some of these patients also had psoriasis, which improved after starting cyclosporine. Cyclosporine is primarily eliminated by the liver, and the parent compound has a terminal half-life of approximately 20 hours. Many of the metabolites of cyclosporine circulate in the blood, and some of them have immunosuppressive activity. Cyclosporine has a rapid onset of action and is one of the most efficacious systemic treatments for psoriasis. Cyclosporine therapy should be limited to the treatment of patients with moderate to severe psoriasis, including those with substantial total body surface area involvement. Cyclosporine may also be useful for major life events such as weddings because it can provide substantial clearing of disease.
