Psoriasis and side-effects of mesotherapy

A 67-year-old woman was referred to our Department in January 1997 with an isomorphic Koebner response due to mesotherapy. The patient has been affected by psoriasis for 10 years and underwent treatment with Cyclosporine A (4-2 mg/kg/day for 12 weeks) 2 years earlier. Since the previous year plaques were treated only with topical preparations, with mild worsening over the autumn. In December 1996 a single mesotherapy was erroneously performed with a cocktail of aminophilline, xantinol nicotinate and lidocaine to treat a left neuralgic sciatica. Two weeks later typical circular psoriatic lesions appeared on the left thigh in the injection's sites (Fig. 1). At the same time, psoriasis worsened on the scalp, trunk, and limbs, while pustular lesions appeared on the palms and soles. The patient was admitted to our Department and underwent treatment with Cyclosporine A with a rapid response (4 mg/kg/day in divided doses for 3 weeks reduced gradually to 2 mg/kg/day and stopped after 14 weeks). Clinical and laboratory examinations excluded further trigger factors for psoriasis.