Non‐biologic immunosuppressive drugs for inflammatory and autoimmune skin diseases

• Published in: Journal der Deutschen Dermatologischen Gesellschaft Vol. 22; no. 3; pp. 400 - 421
• Main Authors: Kanatoula, Danai Dionysia, Bodner, Euna, Ghoreschi, Kamran, Meier, Katharina, Solimani, Farzan
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01.03.2024
• Subjects: Autoimmune Diseases - drug therapy; Azathioprine; Azathioprine - therapeutic use; Breast feeding; Dapsone; Dapsone - therapeutic use; Female; Humans; Hydroxychloroquine; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Infectious diseases; Malignancy; Methotrexate; Methotrexate - therapeutic use; Pregnancy; Skin Diseases; Vaccination
• ISSN: 1610-0379; 1610-0387; 1610-0387
• DOI: 10.1111/ddg.15270

Summary Non‐biologic immunosuppressive drugs, such as azathioprine, dapsone or methotrexate are fundamental treatment options for a wide range of autoimmune and chronic inflammatory skin diseases. Some of these drugs were initially used for malignancies (e.g., azathioprine or methotrexate) or infectious diseases (e.g., hydroxychloroquine or dapsone) but are nowadays mostly used for their immunosuppressive/immunomodulating action. Although dermatologists have years of clinical experience with these drugs, some of the mechanisms of action are not fully understood and are the subject of research. Although these drugs are commonly used, lack of experience or knowledge regarding their safety profiles and management leads to skepticism among physicians. Here, we summarize the mechanism of action and detailed management of adverse effects of the most commonly used immunosuppressive drugs for skin diseases. Furthermore, we discuss the management of these drugs during pregnancy and breastfeeding, as well as their interaction and handling during vaccination.