AZATHIOPRINE IN THE TREATMENT OF PARTHENIUM-DERMATITIS

Background Parthenium dermatitis is a chronic disorder whose managemen t is extremely difficult. Allergen avoidance is almost impossible, top ical corticosteroid therapy provides only partial relief, and prolonge d systemic corticosteroid therapy has unacceptable side-effects. Metho ds Twenty patients with chronic Parthenium dermatitis, with relative c ontraindications to systemic corticosteroids or their side-effects, we re treated with oral azathioprine (100-150 mg daily). The severity of dermatitis was assessed at 0, 1, 3, 6, and 12 months using a modified PASI scoring system. Results The mean age of the patients was 54 years (range, 40-72 years) and the mean duration of dermatitis was 7.6 year s (range, 3 months to 36 years). The mean initial score was 18.9 (rang e, 3.3-42), which decreased to 8.8 (range, 1.6-18.2) at 3 months, 4.8 (range, 0.6-14.6) at 6 months, and 0.7 (range, 0.2-1.4) at 12 months. Of the 15 patients evaluated at 6 months, all but one showed a respons e. Ten (66.6%) patients showed near-total clearance, i.e, reduction in score by more than 90%, and three patients (20%) showed more than 50% reduction in score. No significant side-effects were noted. Conclusio ns Azathioprine is an effective and safe alternative to corticosteroid therapy in the treatment of chronic Parthenium dermatitis. It is espe cially useful in patients with side-effects or contraindications to co rticosteroid therapy.