Single Blind Randomized Controlled Trial of ‘Azathioprine Versus Corticosteroids in Parthenium Hysterophorus Induced Contact Dermatitis’

Abstract

Parthenium dermatitis is a common physically, psychologically and financially debilitating condition faced mostly by farmers in certain parts of India, especially the northern belt of Karnataka. Aim:To study the effectiveness of Azathioprine and corticosteroids in patients with Parthenium hysterophorus induced airborne contact dermatitis and to monitor side effects and duration of relapse. Materials and Methods:34 patients with Parthenium induced air-borne contact dermatitis, diagnosed clinically and proven by positive patch tests with Parthenium were included and randomized into 2 groups of 17 each, the first receiving 100 mg Azathioprine daily for 6 months, and the other 30 mg Prednisolone in tapering doses for 2 months and placebo for 4 months. Disease activity, itch and sleep loss were scored and monitored. Result:In the Azathioprine group, six out of 7 patients who completed treatment showed more than 50% improvement after 3 months of treatment with a longer remission lasting from 2-15 months, whereas in Prednisolone group, 8 out of 13 people who completed treatment showed significant improvement but relapsed on stopping treatment. Severe side effects were not seen in both groups. Conclusion:Azathioprine gives lasting results, a stable prolonged relapse free period and is suitable for a chronic problem like Parthenium dermatitis, but has to be used with caution with proper monitoring. Prednisolone is ideal for acute severe flare ups as a short course therapy, with an early withdrawal for avoiding associated morbidities.