The first experience of using a combination of azathioprine and narrowband UVB 311-nm therapy in atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing, immune-inflammatory pruritic skin disease that significantly reduces quality of life. In some patients with moderate to severe forms, resistant to standard therapy, persistent itching and high disease activity remain, justifying the search for pathogenetically grounded combination approaches.

AIM: To evaluate the clinical efficacy and safety profile of combination therapy with azathioprine and narrowband UVB-311 nm (Patent Reg. No. 2025115441) in patients with moderate to severe refractory AD.

METHODS: The study included 20 patients (14 men, 6 women; 18–60 years) diagnosed with AD according to Hanifin and Rajka criteria. Patients received oral azathioprine 50 mg twice daily for 3–4 weeks alongside UVB-311 phototherapy (4 sessions per week, 12–16 sessions; starting single dose 0.1–0.2 J/cm² with increments of 0.1 J/cm²). Clinical efficacy was assessed using SCORAD, DLQI, and Prurindex. Laboratory monitoring included CBC, biochemistry (ALT, AST, bilirubin, creatinine), and TPMT (thiopurine methyltransferase).

RESULTS:By the end of the treatment course, a significant reduction in pruritus was observed: mean Prurindex scores decreased from 8.2±0.7 to 1.8±0.4 in the morning; from 8.4±0.6 to 2.0±0.3 in the afternoon; and from 9.2±0.8 to 2.3±0.5 in the evening. Over 1 month, the mean SCORAD decreased from 48.5±3.2 to 18.2±2.8 (transition from moderate to mild severity), and the mean DLQI declined from 19.5 to 6.0 (from “very large” to “moderate” impact). Laboratory parameters remained within reference ranges.

CONCLUSION:Combination therapy with azathioprine and UVB-311 provides a relatively rapid and pronounced clinical response with substantial reduction in pruritus and may be considered an important alternative strategy for managing refractory forms of AD with a manageable safety profile