Sequential combined therapy with thalidomide and narrow-band (TL01) UVB in the treatment of prurigo nodularis.
BACKGROUND
Prurigo nodularis (PN) is a chronic disease of which treatment choices are limited. Among them, thalidomide and phototherapy have been used with satisfactory results. Unfortunately, the possibility of side effects limits their use.


OBJECTIVE
To evaluate the efficacy of a sequential combined treatment with thalidomide and ultraviolet B (UVB) therapy in order to minimize side effects and, thus, making possible a long-term treatment.


METHODS
A prospective open trial combining thalidomide as initial therapy followed by narrow-band UVB (TL01) irradiation until complete or almost complete remission of the disease was achieved.


RESULTS
An excellent response was obtained after an average of 12 weeks of thalidomide therapy and 32 UVB courses.


CONCLUSIONS
Sequential combined therapy with thalidomide and narrow-band UVB therapy could improve the management of prurigo nodularis with minimal side effects, although it should probably be reserved to men and women over 50 years of age.
Ferrándiz
C
C
Servei de Dermatologia, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.
Carrascosa
J M
JM
Just
M
M
Bielsa
I
I
Ribera
M
M
D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011536:Prurigo / Q000188:drug therapy* / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012008:Recurrence; D012074:Remission Induction; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014466:Ultraviolet Rays / Q000145:classification; D014467:Ultraviolet Therapy / Q000009:adverse effects
D007166:Immunosuppressive Agents; D013792:Thalidomide