The use of azathioprine in severe adult atopic eczema

Aim To evaluate the use of azathioprine in the treatment of severe adult atopic eczema and review the relevant literature. Background Effective treatment of severe adult atopic eczema may necessitate the use of agents such as systemic steroids, PUVA or cyclosporin, which are associated with significant morbidity. Azathioprine is an effective alternative which can induce disease remission and may be less toxic. Methods Ten patients treated with azathioprine 0.7-2.5 mg/kg per day for a minimum period of 12 months were evaluated in a retrospective follow-up study. Results Clearance or marked improvement was noted in eight patients; three of these later became refractory to the drug. Side-effects were few and were well-tolerated. One patient was found to have lymphoma 8 months after stopping treatment. Conclusion Azathioprine is an effective and cheaper alternative to cyclosporin in the treatment of severe adult atopic eczema. Its long-term toxicity remains unclear. (C) 1998 Elsevier Science B.V. All rights reserved.