Cyclosporin A-induced gingival hyperplasia in psoriasis: review of the literature and case reports.

Cyslosporin A (CyA) treatment of psoriasis is warranted in severe cases where other, conventional antipsoriatic approaches have failed. Gingival hyperplasia is a rare side effect of cyclosporin A treatment in psoriasis patients. Previous studies in cyclosporin A-treated patients (mostly transplant recipients) have demonstrated correlation between cyclosporin A serum levels and oral hygiene status on the one hand, and the prevalence and severity of this overgrowth on the other hand. Severe cases of gingival overgrowth may call for radical treatments such as periodontal surgery. Our aim was to present a severe form of cyclosporin A-induced hyperplasia in two female patients and to give an overview of the current literature on the issue. High serum levels of cyclosporin A were observed in both patients. Moreover, high initial plaque accumulation was noted in both patients. Upon cessation of drug administration and a combined periodontal treatment, virtually complete reduction of the gingival enlargement and inflammation was observed. Consequently, early diagnosis and an all-inclusive treatment of cyclosporin A-induced hyperplasia can result in virtually complete remission of the symptoms and eliminate the need of aggressive treatments such as periodontal surgery.