SUMMARYNormal skin of healthy individuals and bolh lesional and uninvolved skin from patienis with psoriasis before and after receiving cyciosporin A (CsA; 25 or 5 mg/kg per day) was examined by immunocytochemislry for differences in expression of adhesion-relevanl epitopes. Normal, lesional and uninvolved skin all showed staining of basal keratinocyiesfor CD29 {the common/i chain of the /JI -integrin family). No other adhesion molecule investigated was detected on structural components of normal skin. In uninvolved skin, weak expression of CD54 (intercellular adhesion molecule I. ICAM-1) was noted on vascular endothelium. Uninvolved keralinocytes were found to stain with anti-CD58 {kucocyte function-associated antigen 3, LFA-3) and there was weak expression of CD 11 b (a chain of complement C3bi receptor) and CD 11 c (a chain of p 150., 95 molecule) bul not CDl la (leucocyte function-associated antigen 1. LFA-I, a chain) on those celts. In icsional skin, in addition to expression of CD58. there was also enhanced expression of CD 11 c. Weak expression of CD54 on keratinocytes was also observed. Lesional blood vessels were found to stain strongly with anti-CD54. CD29 and CD58. CDI la was expressed only on infiltrating mononuclear celts. CsA treatment produced marked clinical improvement, accompanied by the loss of CD54 expression on keralinoeytes. However, despite the loss of T celts from lesionat skin with CsA treatment. CD54 persisted on blood vessels. CsA was found to have no effect on keratinocyte expression of CD29. CD58orCDl Ibandc. ThepersisteneeofCD54on vascular endothetium and of adhesion molecule expression on keratinocytes. despite resolution of the skin lesions, may explain the universal and rapid recurrence of psoriasis on cessation of CsA administration.