Table 1.

Non‐biologic conventional immunomodulators

Agent	Common uses in skin disease	Infection risk
Methotrexate	Psoriasis Atopic dermatitis Bullous pemphigoid Alopecia areata Cutaneous lupus	Minor increased risk of infection, mainly skin and respiratory tract infections 22 , 23 , 24 No apparent increased risk of serious infection
Ciclosporin	Atopic dermatitis Psoriasis Pyoderma gangrenosum	Minor increased risk of infection, mainly upper respiratory tract infections 25 , 26 Possible role in coronavirus infection treatment due to in vitro activity 27
Azathioprine	Pemphigus vulgaris Bullous pemphigoid Alopecia areata Atopic dermatitis	Moderately increased risk of serious infection 28 Risk may be higher in immunobullous disease due to patient age and prolonged corticosteroid therapy 29 Increased risk of herpes virus infection 30
Mycophenolate mofetil/ mycophenolic acid	Atopic dermatitis Cutaneous lupus Pemphigus vulgaris Bullous pemphigoid Cutaneous lupus	At least moderately increased risk of infection, mainly upper respiratory tract and urinary tract infections Increased risk of herpes virus infections 31
Hydroxychloroquine	Cutaneous lupus	Protective against infection in patients with lupus 32 Efficacy in COVID‐19 infection being explored in clinical trials; 33 in vitro activity of chloroquine against COVID‐19
Systemic corticosteroids (predniso(lo)one ≥20 mg)	Many	Significant increase in risk of infection