Successful treatment of severe atopic dermatitis in a child and an adult with the T-cell modulator efalizumab.

An 8-year-old white boy presented in January 2003 with a long-standing history of atopic dermatitis, with onset between ages 1 and 2 years, in addition to insulindependent diabetes mellitus diagnosed at age 7 years. During the prior 6 years, he had undergone treatment with a variety of topical corticosteroids, 1% pimecrolimus cream, emollients, and courses of prednisone. Both diseases were poorly controlled. The patient was initially treated with 0.05% diflorasone diacetate ointment, petroleum jelly, and oral cetirizine. In February 2003, 4 mg/kg per day of oral cyclosporine was added to his regimen. This was subsequently increased to 5.6 mg/kg per day in late March and to 6.2 mg/kg per day in late April. In March and May 2003, he received 2 courses of oral cephalexin for flares.