Which statement describes cyclosporine's role in SJS/TEN?

• A. Increases infection risk
• B. Limited by short course of therapy
• C. Considered 2nd line to patients intolerant of IVIG
• D. It is the preferred first-line therapy

Answer: (C)

In SJS/TEN, the goal is to halt the immune attack and support skin healing. Cyclosporine works by inhibiting calcineurin, which reduces T-cell activation and keratinocyte apoptosis. This immune-modulating effect can help stop the progression of skin detachment and promote recovery. Because IVIG is often used as a first-line immunomodulatory option in many centers, cyclosporine is typically reserved for patients who cannot receive IVIG or who do not tolerate it. That makes it a second-line therapy in those scenarios. While cyclosporine carries risks like infection and kidney toxicity, its role is defined by its use as an alternative when IVIG isn’t suitable, rather than as the first-line treatment.