SEVERE AND CHRONIC ALLERGIC CONTACT-DERMATITIS RESPONDING TO AZATHIOPRINE THERAPY

Allergic contact dermatitis (ACD) can be persistent and difficult to t reat, Indeed, in ACD from chromate, less than 20% of cases are clear a fter 10 years, Oral cyclosporin A has been used in severe ACD, There a re few reports regarding the use of azathioprine, We report two cases of ACD from chromate and two from sesquiterpene lactone which responde d well to azathioprine therapy, None of the cases had responded adequa tely to potent topical steroids or allergen avoidance, Our cases illus trate that azathioprine 0.2 mg/kg daily is a simple, cheap and effecti ve treatment, both in the short and long term, Azathioprine is cheaper and has fewer side-effects than cyclosporin and so may be preferable as an initial systemic therapy, Azathioprine may be effective in other forms of allergic contact dermatitis.