High Doses Intravenous Immunoglobulin versus Oral Cyclosporine in the Treatment of Severe Atopic Dermatitis

Atopic dermatitis is one of the most common allergic diseases that almost alwaysrespond to conventional therapies with topical emollient, topical corticosteroids,systemic antihistamines and allergic abstinence. however few cases of atopicdermatitis with severe course do not respond to conventional therapies and high doseof intravenous immunoglobulin or cyclosporine are recommended for them. thisclinical trial study has been done to compare the last two regimens in patients withsevere atopic dermatitis, scoring atopic dermatitis (scorad) > 70. we included 14patients in two groups. in group 1, eight patients were randomly selected and received4mg/kg cyclosporine daily for 3 months and in group 2, six patients received 2g/kgintravenous immunoglobulin (ivig) as stat infusion. all patients were followed ondays 15, 30, 60 and 90 after starting the therapy. about 75% and 62.5% of patients hadpositive skin tests to egg and to milk respectively. six patients out of 14 patients didnot have skin test, so specific ige by radioallergosobent tests (rast) was used forthem. all of these patients had positive rast to egg and 66.6% against cow’s milk.there was a significant difference in the clinical outcomes of these two groups witha marked reduction in scorad of day 90th in group 1 in comparison to group 2 (pvalue= 0.005). no significant adverse drug reaction was seen in these two groups