title: Systemic treatment of papular dermatitis: A retrospective study.
abstract: BACKGROUND
  Papular dermatitis is an intensely pruritic eruption that is often refractory to conventional therapy.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the efficacy of different non-steroidal systemic therapies for long-term control of disease in patients with papular dermatitis.
  
  
  METHODS
  This was a single center, retrospective study involving a chart review of patients with a diagnosis of papular dermatitis who were prescribed systemic therapy between 1 January 2002 and 31 December 2012.
  
  
  RESULTS
  Fourteen patients were identified that were treated with a systemic agent. Median duration of treatment was 25 months. Methotrexate was used first line in 12 patients, with control of disease achieved in eight patients with a dose between 2.5 and 10 mg weekly. Azathioprine and mycophenolate mofetil also provided control of disease when used as first-line therapy in the remaining two patients. While azathiopurine was effective in patients who failed methotrexate, gastrointestinal side effects limited its use long term.
  
  
  CONCLUSIONS
  Low dose weekly methotrexate, as well as, azathioprine and mycophenolate mofetil are long-term treatment options for patients with papular dermatitis refractory to other therapies.
authors: a Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors: Farah A
authors: FA
authors: Moustafa
authors: a Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors: Laura F
authors: LF
authors: Sandoval
authors: a Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors: Joseph L
authors: JL
authors: Jorizzo
authors: a Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors: William W
authors: WW
authors: Huang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage*; D003872:Dermatitis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate
keywords: Azathiopurine; methotrexate; mycophenolate mofetil; papular dermatitis; systemic agents