Effectiveness of Cyclosporine in Parthenium Dermatitis: A Prospective Study to Evaluate Treatment Outcomes and Inflammatory Cytokine Levels

BACKGROUND: Parthenium dermatitis is a chronic relapsing allergic Contact Dermatitis caused by Parthenium hysterophorus presenting therapeutic challenges. Cyclosporine, a calcineurin inhibitor with rapid anti-inflammatory effects, may be useful for short-term disease control. OBJECTIVE: To evaluate the effectiveness and safety of cyclosporine in parthenium dermatitis and correlate treatment response with inflammatory cytokine levels. METHODS: Ths prospective, open-label study enrolled 50 patch test-positive patients treated with cyclosporine (2.5 mg/kg/day) for up to 12 weeks. Clinical severity scores (CSS) and adverse effects were monitored. Serum cytokines (TNF-α, IL-6, IL-17, IL-10) were assessed pre- and post-treatment in 27 patients. Patients were followed monthly for 3 months post-treatment to assess relapse. RESULTS: Of 48 ptients who were evaluated, 35 (72.9%) achieved complete remission (CSS = 0), and 7 (14.6%) showed significant improvement. IL-6 levels decreased significantly post-treatment (p = 0.0003), while TNF-α and IL-17 showed a non-significant decline. IL-10 levels remained unchanged. Relapse occurred in 69% of patients within a mean of 2.9 weeks after treatment cessation. CONCLUSION: Cyclosporine is an effective short-term therapy for parthenium dermatitis, but relapse is frequent after abrupt withdrawal. Tapering or transitioning to steroid-sparing agents may enhance long-term control. Reduction in IL-6 highlights its role in disease pathogenesis and response to immunosuppression.