Which medications in the drug class Immunosuppressants are used in the treatment of Vesicular Palmoplantar Eczema?

Updated: Aug 23, 2019
  • Author: Jessica Dunkley, MD, MHSc, CCFP; Chief Editor: Dirk M Elston, MD  more...
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These agents are used for severe acute episodes and as steroid-sparing agents in the chronic forms of the disease.

Azathioprine (Azasan, Imuran)

Azathioprine antagonizes purine metabolism and inhibits the synthesis of DNA, RNA, and proteins. It may decrease the proliferation of immune cells, resulting in low autoimmune activity. It is used in transplant recipients and some autoimmune conditions.

Cyclosporine (Gengraf, Neoral, Sandimmune)

Cyclosporine is a calcineurin inhibitor. It is a potent immunosuppressant and  is nonmyelotoxic but markedly nephrotoxic. It is widely used in organ and tissue transplantation and skin diseases (eg, psoriasis, atopic dermatitis).

Methotrexate (Rheumatrex, Trexall)

Methotrexate is an antimetabolite; it inhibits the enzyme dihydrofolate reductase, which is essential for purine and pyrimidine synthesis. It has an unknown mechanism of anti-inflammatory action. Folinic acid after methotrexate administration helps prevent methotrexate-induced mucositis or myelosuppression.

Mycophenolate (CellCept, Myfortic)

Mycophenolate is an immunosuppressant used to prevent acute rejection of renal or cardiac transplants. It inhibits inosine monophosphate dehydrogenase (IMPDH) and suppresses de novo purine synthesis by lymphocytes, inhibiting their proliferation. It inhibits antibody production.

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