Three Cases of Refractory Psoriasis Treated with Low-dose Azathioprine and Acitretin Combined Therapy / 대한피부과학회지

ABSTRACT

Azathioprine is an imidazole derivative of 6-mercaptopurine and is well known for its role in T and B lymphocyte inhibition. These properties have made it useful in the treatment of organ transplant rejection, rheumatoid arthritis, and severe psoriasis. We studied the effects of low-dose azathioprine and acitretin combined therapy in 3 cases of refractory psoriasis. The patients had previously been treated with other systemic and topical therapies. Although they had received partial and temporary benefits, they were not controlled effectively. These patients were subsequently treated with azathioprine and acitretin. Azathioprine treatment (50-100 mg/day) in combination with acitretin (10 mg/day) showed marked improvement of recalcitrant psoriasis. There were no noticeable major side effects associated with this course of treatment. In conclusion, some cases of recalcitrant psoriasis may be effectively and safely controlled using low-dose of azathioprine and acitretin combined therapy.