Ho V C, Zloty D M
Division of Dermatology, University of British Columbia, Vancouver, Canada.
Dermatol Clin. 1993 Jan;11(1):73-85.
Azathioprine, cyclophosphamide, and cyclosporine are immunosuppressive agents commonly used by dermatologists. Azathioprine has a good safety profile and is preferred by most dermatologists for the treatment of bullous pemphigoid, cutaneous vasculitides, chronic eczematous dermatitides, and cutaneous manifestations of connective tissue diseases. For more fulminant diseases such as Wegener's granulomatosis, lymphomatoid granulomatosis, severe cases of systemic lupus erythematosus, or pemphigus, cyclophosphamide is more effective and its use is justified even though it is more toxic. Cyclosporine has been shown to be effective in a variety of dermatoses; the most promising results are seen in psoriasis, lichen planus, pyoderma gangrenosum, and chronic eczematous dermatitides. The long-term safety of cyclosporine remains to be determined, and it should be used judiciously with careful evaluation of the risk-benefit ratio in each case. Dermatologists who use immunosuppressive agents should be familiar with their indications, side effects, dosage, and monitoring.
硫唑嘌呤、环磷酰胺和环孢素是皮肤科医生常用的免疫抑制剂。硫唑嘌呤具有良好的安全性，大多数皮肤科医生更倾向于用其治疗大疱性类天疱疮、皮肤血管炎、慢性湿疹性皮炎以及结缔组织病的皮肤表现。对于像韦格纳肉芽肿、淋巴瘤样肉芽肿、重症系统性红斑狼疮或天疱疮等更严重的疾病，环磷酰胺更有效，尽管其毒性更大，但使用它是合理的。环孢素已被证明对多种皮肤病有效；在银屑病、扁平苔藓、坏疽性脓皮病和慢性湿疹性皮炎中可看到最有前景的疗效。环孢素的长期安全性仍有待确定，应谨慎使用，并在每种情况下仔细评估风险效益比。使用免疫抑制剂的皮肤科医生应熟悉其适应证、副作用、剂量和监测。
