Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany.
J Dtsch Dermatol Ges. 2024 Mar;22(3):400-421. doi: 10.1111/ddg.15270. Epub 2024 Jan 23.
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.
非生物免疫抑制剂，如硫唑嘌呤、氨苯砜或甲氨蝶呤，是广泛的自身免疫性和慢性炎症性皮肤病的基本治疗选择。这些药物中的一些最初用于恶性肿瘤（如硫唑嘌呤或甲氨蝶呤）或传染病（如羟氯喹或氨苯砜），但现在主要用于其免疫抑制/免疫调节作用。尽管皮肤科医生对这些药物有多年的临床经验，但其中一些作用机制尚未完全了解，仍是研究的主题。尽管这些药物被广泛使用，但由于缺乏对其安全性和管理的了解，导致医生对此持怀疑态度。在这里，我们总结了最常用于皮肤病的免疫抑制剂的作用机制和不良反应的详细管理。此外，我们还讨论了这些药物在妊娠和哺乳期的管理，以及它们在疫苗接种期间的相互作用和处理。
