ITGAL and progressive multifocal leukoencephalopathy: The decision to implement therapy with immunosuppressants must be derived from a precise understanding of these agents and the often formidable adverse reactions that accompany their use (efalizumab which inhibit CD11a has been associated with PML progressive multifocal leukoencephalopathy [10]), for inflammatory and autoimmune-related skin disorders as psoriasis which is not life-threatening; it is incumbent on the treating physicians to determine that immunosuppressants are the appropriate form of treatment.