Although data on the use of azathioprine for atopic dermatitis are limited, there are several studies that support its use as a second-line treatment for severe, refractory disease. Background. Azathioprine is efficacious in the treatment of severe childhood atopic dermatitis; however, robust data on adverse effects in this population are lacking. 1. Br J Dermatol. 2002 Aug;147(2):324-30. Azathioprine in severe adult atopic dermatitis: a double-blind, placebo-controlled, crossover trial. Azathioprine for severe atopic eczema. This leaflet is about the use of azathioprine for the treatment of severe atopic eczema. This leaflet has been written specifically about the use of this medicine in children. Azathioprine is mainly used in the UK to treat people with severe atopic eczema that is unresponsive to normal topical treatment. The reasons for prescribing azathioprine are similar to those for ciclosporin, Azathioprine is recommended as a systemic agent for the treatment of refractory atopic dermatitis. The effectiveness of azathioprine for treating inflammatory diseases, including atopic dermatitis, is well established. The thiopurine methyltransferase (TPMT) polymorphism is associated with azathioprine toxicity. Oral azathioprine for recalcitrant pediatric atopic dermatitis: Clinical response and thiopurine monitoring Presented in part in poster format at the Society for Pediatric Dermatology 2011 Annual Meeting, Baltimore, MD, July 7-10, 2011. Concomitant allopurinol: Azathioprine dose should be reduced to 25% to 33% of the usual dose. Further dose reduction or alternative therapies should be considered for patients with low or absent TPMT activity. In the case of azathioprine, these are atopic eczema, bullous pemphigoid, pyoderma gangrenosum, chronic actinic dermatitis and cutaneous vasculitis. Will azathioprine cure my skin condition? None of the skin conditions for which azathioprine is used are “cured” by this treatment. Usually a gradual improvement is seen. However, this may take many years. How long will I need to take.