AZATHIOPRINE IN DERMATOLOGY - A SURVEY OF CURRENT PRACTICE IN THE UK

Azathioprine has an important role in treatment of many inflammatory d ermatoses. In view of the current emphasis on evidence-based medicine, we performed a questionnaire-based survey to establish current practi ce in the use of azathioprine by consultant dermatologists and associa te specialists in the U.K. The response rate was 68%. In contrast with the manufacturer's recommendation, our data provide evidence that aza thioprine is useful in the treatment of a wide variety of dermatologic al diseases. However, there is still a need for controlled trials in s ome conditions. The most common conditions treated were pemphigoid, pe mphigus and atopic eczema. In addition, we found that only 13% of derm atologists prescribe azathioprine according to body weight. Most derma tologists felt that azathioprine was well tolerated. No one tested for thiopurine methyltransferase (TPMT) activity, which is thought to be a predictor of severe myelosuppression. The combination of prescribing azathioprine according to body weight and measuring TPMT activity wou ld optimize efficacy and minimize potential severe myelotoxicity.