A practical approach to using azathioprine

Azathioprine is a useful immunosuppressant in dermatology. Introduced as a steroid-sparing agent in the 1960s for renal transplant recipients, it has been used as both an immunosuppressant and a steroid-sparing agent for inflammatory disease. In dermatology, it is particularly useful for treating patients with immunobullous diseases, lupus erythematosus, vasculitis, chronic actinic dermatitis and severe atopic eczema. The onset of action is slow, taking six to eight weeks, so it is more suitable for long-term disease control and is of little use in managing flares.