Parthenium dermatitis treated with azathioprine weekly pulse doses.
BACKGROUND
Parthenium dermatitis is a serious problem in India. Corticosteroids are the mainstay of treatment but the prolonged use of corticosteroids can cause serious side effects. Azathioprine used in daily doses has been shown to be effective.


OBJECTIVE
We have evaluated the effectiveness of azathioprine weekly pulse doses for the treatment of parthenium dermatitis.


METHODS
Twelve patients, ten males and two females, aged between 39 and 65 years (mean +/- SD = 53.5 +/- 8.7) having air-borne contact dermatitis to Parthenium hysterophorus for 3-19 years (mean = 6.33) were included in the study. The diagnosis in each patient was confirmed by patch-testing. The severity of the disease was determined by clinical severity score (CSS) on the basis of erythema, itching, type of lesions, and areas of body involved.


RESULTS
The pretreatment CSS in these patients varied from 29.7 to 55.5 (mean +/- SD: 40.40 +/- 7.95). After clinical and laboratory evaluation, the patients were treated with 300-mg azathioprine once-weekly doses for 6 months. Clinical and laboratory evaluations were repeated at weeks 1, 2, and then every 4 weeks until the end of therapy to evaluate the therapeutic response and side effects. The response was excellent (80-100% clearance of disease) in seven (58.33%) patients and good (60% clearance) in five (41.66%) patients. The post-treatment CSS decreased from the mean +/- SD of 40.4 +/- 7.95 to 10.9 +/- 8.43 (P = 0.002). There were no significant side effects of the therapy.


CONCLUSIONS
In this preliminary open study, azathioprine in weekly pulse doses has been found to be effective without any serious adverse effects in the treatment of parthenium dermatitis. The cost of therapy with this regimen is reduced by 60%.
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India. prokverma@hotmail.com
Kaushal K
KK
Verma
Arika
A
Bansal
G
G
Sethuraman
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage*; D003877:Dermatitis, Contact / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D020903:Tanacetum parthenium / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D001379:Azathioprine