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Please cite this article as: Morgado-Carrasco D, Fustà-Novell X, Iranzo P. FR-Ciclosporin as a First-Line Treatment in Epidermal Necrolysis. Actas Dermosifiliogr. 2019;110:601--603. ∗ Corresponding author. E-mail address: [email protected] (P. Iranzo). associated with high mortality, which can be accurately predicted based on the score for toxic epidermal necrolysis (SCORTEN). There is consensus regarding patient hospitalization and management in a specialist intensive care unit, which is associated with improved survival. Treatments with corticosteroids, classical immunosuppressants, anti-tumor necrosis factor (anti-TNF) agents, intravenous immunoglobulins (IVIG), and plasmapheresis have been described, despite a lack of clear evidence supporting their efficacy. González-Herrada et al recently published the results of a study conducted in 2 burn units in Madrid. In the first unit, at the Hospital Universitario de Getafe (HUG), EN patients were mainly treated with ciclosporin (3 mg/kg/d) until re-epithelialization [Table 1]). In the second unit, at the Hospital Universitario La Paz (HULP), patients were mainly treated with IVIG without ciclosporin. These 2 units provided the necessary conditions for a ‘‘natural’’ clinical trial. The study population consisted of 71 EN patients aged 14 years and older. The authors performed 3 types of analysis. The first focused on 42 individuals living in Madrid who were treated at either HUG (n = 23) or HULP (n = 19). Of these, 22 and 4, respectively, were treated with ciclosporin. One patient (4.3%) died at HUG and 6 (31.6%) at HULP. When hospital allocation was included in the analysis as an