[Severe adult atopic dermatitis: treatment with mycophenolate mofetil in 8 patients].

BACKGROUND Atopic dermatitis (AD) includes severe forms that can be refractory to various systemic treatments. Mycophenolate mofetil (MMF) has been found to be useful in patients with severe forms of AD and to have fewer side effects than long-term treatment with oral corticosteroids or cyclosporine. OBJECTIVES To evaluate the efficacy and adverse effects of MMF in patients seen in our skin allergy unit with severe adult AD refractory to other systemic treatments. METHODS We performed a retrospective study of 8 patients with severe adult AD treated with MMF, analyzing the baseline characteristics, previous treatments used by the patients, and the outcome and adverse effects of treatment with MMF. RESULTS Five patients treated with MMF showed improvement in the fourth week of treatment. In addition, 5 of the 8 patients presented a clear, long-term improvement in their disease. Remission of AD occurred in 1 patient, making it possible to discontinue MMF; this patient remains stable with no relapses after 4 months without treatment. The other 4 patients continue on maintenance therapy. Three patients continued to have frequent acute outbreaks of AD despite treatment with MMF for 16 to 72 weeks. All patients tolerated the treatment and there were few adverse effects. CONCLUSIONS MMF can be an effective option in selected patients with severe forms of atopic dermatitis. Although the response is not as rapid as with oral corticosteroids or cyclosporine, it can be used for maintenance treatment with good clinical control and few adverse effects.