{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:24:22Z","timestamp":1787840662492,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n In progressive vitiligo, systemic corticosteroids as oral mini-pulse (OMP) have been successfully used, yet there is limited data regarding other immunosuppressants, such as azathioprine (AZA).<\/jats:p>\n <\/jats:sec>\n \n Aim and Objectives:<\/jats:title>\n We aimed to evaluate the efficacy and safety of AZA in stabilizing active vitiligo, and compare it with its combined use with narrow - band ultraviolet B (NB-UVB) and OMP combined with NB-UVB.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n Forty-five adult active non-segmental vitiligo (NSV) patients were randomly and equally divided into three groups. Patients received treatment for 3 months. Patients in Group A received NB-UVB with OMP, those in Group B received NB-UVB combined with oral AZA, and patients in Group C received oral AZA alone. Treatment response was evaluated at 4, 8, and 12 weeks by assessing the cessation of vitiligo activity, the onset of re-pigmentation, and its extent using vitiligo extent score (VES), VES plus, and vitiligo disease activity (VIDA) scores. Encountered side effects were also documented.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Results revealed significant differences between study groups in decrease in VES and VES plus scores (incidence of re-pigmentation) after 12 weeks of treatment (Groups A and B had superior re-pigmentation than Group C). There was no significant difference among the groups in cessation of vitiligo activity (although more patients experienced a faster onset in Group A and B compared to Group C). Encountered side effects were minimal, with no significant difference.<\/jats:p>\n <\/jats:sec>\n \n Limitations:<\/jats:title>\n Small sample size, short duration of follow-up and not carrying out thiopurine methyl transferase activity<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n AZA is effective in controlling vitiligo activity, either as monotherapy or in combination with NB-UVB. However, it is inferior to the combination of OMP with NB-UVB in inducing re-pigmentation. Thus, AZA can be used as a good alternative to stop vitiligo progression when systemic steroids are contraindicated.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/idoj.idoj_669_24","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T09:00:37Z","timestamp":1749632437000},"page":"581-585","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Value of Azathioprine in Controlling Vitiligo Activity"],"prefix":"10.4103","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0028-4686","authenticated-orcid":false,"given":"Rania","family":"El-Husseiny","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourhan Abd","family":"El-Hafez","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Andrology, Alhaud Almarsoud Dermatology Hospital, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7791-9141","authenticated-orcid":false,"given":"Marwa","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"R1-20250703","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1111\/jdv.15604","article-title":"Clinical signs of disease activity in vitiligo:A systematic review and meta-analysis","volume":"33","author":"Van Geel","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R2-20250703","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2310\/7750.2013.12053","article-title":"Low-dose oral mini-pulse dexamethasone therapy in progressive unstable vitiligo","volume":"17","author":"Kanwar","year":"2013","journal-title":"J Cutan Med Surg"},{"key":"R3-20250703","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/phpp.12749","article-title":"Efficacy of narrow band UVB with or without OMP in stabilization of vitiligo activity in skin photo-types (?- ?):A double- blind, randomized, placebo- controlled, prospective, multicenter study","volume":"38","author":"Esmat","year":"2022","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"R4-20250703","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/09546630600791442","article-title":"The efficacy of combined PUVA and low-dose azathioprine for early and enhanced re-pigmentation in vitiligo patients","volume":"17","author":"Radmanesh","year":"2006","journal-title":"J. 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Guidelines for prescribing azathioprine in dermatology","volume":"151","author":"Anstey","year":"2004","journal-title":"Br J Dermatol"},{"key":"R11-20250703","doi-asserted-by":"crossref","first-page":"357","DOI":"10.4103\/0378-6323.42905","article-title":"An open labeled, comparative clinical study on efficacy and tolerability of oral minipulse of steroid (OMP) alone, OMP with PUVA and broad\/narrow band UVB phototherapy in progressive vitiligo","volume":"74","author":"Rath","year":"2008","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R12-20250703","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/dth.12384","article-title":"The role of systemic steroids and phototherapy in the treatment of stable vitiligo:A randomized controlled trial","volume":"29","author":"EL Mofty","year":"2016","journal-title":"Dermatol Ther"},{"key":"R13-20250703","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/09546634.2017.1339013","article-title":"Importance of light in the treatment of vitiligo with JAK-inhibitors","volume":"29","author":"Joshipura","year":"2017","journal-title":"J Dermatol Treat"},{"key":"R14-20250703","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1067\/mjd.2001.113475","article-title":"Oral dexamethasone pulse treatment for vitiligo","volume":"44","author":"Radakovic-Fijan","year":"2001","journal-title":"J Am Acad Dermatol"}],"container-title":["Indian Dermatology Online Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_669_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:26:44Z","timestamp":1787837204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_669_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/idoj.idoj_669_24","relation":{},"ISSN":["2229-5178","2249-5673"],"issn-type":[{"value":"2229-5178","type":"print"},{"value":"2249-5673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,10]]},"assertion":[{"value":"2024-07-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}