Clinical improvement and significant reduction of total serum IgE in patients suffering from severe atopic dermatitis treated with oral azathioprine.

Atopic dermatitis (AD) is a common inflammatory skin disease: the incidence is increasing in many countries and treatment can be difficult. The aim of this retrospective case series was to examine the effect of oral azathioprine on the clinical severity and serum IgE levels in 38 patients with severe atopic dermatitis. The AD was well-controlled in nearly 80% (30/38). The maintenance dose required was in the range 25-200 mg per day. Four patients withdrew because of adverse affects, including one case of pancytopenia, and a further four ceased azathioprine after 4 months because of a lack of clinical improvement. Total serum IgE levels were measured before commencing azathioprine and after two years of treatment in 26 patients. IgE levels decreased in almost all patients and this was statistically significant (P = 0.012).