Antipruritic effect of azathioprine in atopic dermatitis: a pilot study

BACKGROUND: Despite the availability of multiple therapeutic options for atopic dermatitis, the search for strategies that effectively control key symptoms of the disease, including pruritus, remains relevant. Azathioprine, used as a systemic immunomodulatory agent, is considered a potential therapeutic option in patients who do not respond to standard treatment. AIM: The study aimed to evaluate the antipruritic effect of azathioprine in patients with atopic dermatitis. METHODS: This pilot study was conducted at the Rakhmanov Clinic of Skin and Venereal Diseases and included 10 patients, namely 8 men and 2 women, aged 18–60 years with atopic dermatitis and persistent, clinically significant pruritus resistant to standard therapy. Participants received 100 mg of oral azathioprine daily for 10 days while maintaining standard basic skin care. RESULTS: Treatment resulted in a substantial reduction in pruritus intensity. Scores on the 6-point Prurindex scale decreased by 74%–78% in all time periods (morning, daytime, evening). Investigator’s Global Assessment scores decreased from a baseline mean of 2.8 to 1.6. Additionally, reduced serum immunoglobulin E levels and decreased severity of inflammatory skin changes were observed. CONCLUSION: Owing to its systemic immunosuppressive mechanism, azathioprine demonstrated a clinically significant antipruritic effect and led to overall clinical improvement. These findings support the potential role of azathioprine in the treatment of chronic inflammatory pruritic dermatoses.