Cyclosporine use in paediatric dermatologic conditions: A comprehensive review of therapeutic applications

Cyclosporine (CsA), an oral calcineurin inhibitor, is frequently used off-label in paediatric dermatology to manage severe inflammatory skin conditions rapidly. The current literature on this topic encompasses various sources, including systematic reviews, meta-analyses, case series, narrative reviews and clinical trials, with a focus on atopic dermatitis, chronic urticaria, drug reaction with eosinophilia and systemic symptoms (DReSS), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), reactive infectious mucocutaneous eruption (RIME) and psoriasis. While some studies include adult data, they support the use of CsA as a viable treatment option in well-selected paediatric patients when accompanied by diligent monitoring. This review highlights common dosing strategies, typically weight-based and reports consistent rapid clinical improvement and steroid-sparing effects. Although adverse events may occur, they are generally reversible; however, careful monitoring is recommended.