Azathioprine in the treatment of Parthenium dermatitis.
BACKGROUND
Parthenium dermatitis is a chronic disorder whose management is extremely difficult. Allergen avoidance is almost impossible, topical corticosteroid therapy provides only partial relief, and prolonged systemic corticosteroid therapy has unacceptable side-effects.


METHODS
Twenty patients with chronic Parthenium dermatitis, with relative contraindications to systemic corticosteroids or their side-effects, were treated with oral azathioprine (100-150 mg daily). The severity of dermatitis was assessed at 0, 1, 3, 6, and 12 months using a modified PASI scoring system.


RESULTS
The mean age of the patients was 54 years (range, 40-72 years) and the mean duration of dermatitis was 7.6 years (range, 3 months to 36 years). The mean initial score was 18.9 (range, 3.3-42), which decreased to 8.8 (range, 1.6-18.2) at 3 months, 4.8 (range, 0.6-14.6) at 6 months, and 0.7 (range, 0.2-1.4) at 12 months. Of the 15 patients evaluated at 6 months, all but one showed a response. Ten (66.6%) patients showed near-total clearance, i.e. reduction in score by more than 90%, and three patients (20%) showed more than 50% reduction in score. No significant side-effects were noted.


CONCLUSIONS
Azathioprine is an effective and safe alternative to corticosteroid therapy in the treatment of chronic Parthenium dermatitis. It is especially useful in patients with side-effects or contraindications to corticosteroid therapy.
Sharma
V K
VK
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Chakrabarti
A
A
Mahajan
V
V
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D019659:Asteraceae; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use*; D003877:Dermatitis, Contact / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents; D001379:Azathioprine