Long-term thalidomide for actinic prurigo.
A 35-year-old man presented at the age of 8 years with recurrent pruritic papulovesicular lesions on his face and body appearing within minutes of light exposure. A recent positive finding of human leukocyte antigen (HLA) DR4 with the rare DRB1*0407 subtype confirmed a diagnosis of actinic prurigo. Thalidomide (100 mg/day) was commenced at the age of 11 years after an unsuccessful trial of other treatments and his lesions resolved within 2 months. Attempts to withdraw thalidomide have resulted in recurrence of photosensitivity and the patient has remained on a virtually continuous maintenance dose of thalidomide (50 mg/ day) for 23 years. His cumulative dose is estimated to be over 400 g. To date, he has not experienced any adverse effects and investigations have shown no evidence of neuropathy. This case illustrates the safe long-term use of thalidomide.
Yong-Gee
S A
SA
Department of Dermatology, Mater Misericordiae Hospital, South Brisbane, Queensland, Australia.
Muir
J B
JB
D000328:Adult; D015804:HLA-DR4 Antigen / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D010787:Photosensitivity Disorders / Q000188:drug therapy*; D011536:Prurigo / Q000188:drug therapy*; D013792:Thalidomide / Q000627:therapeutic use*
D015804:HLA-DR4 Antigen; D007166:Immunosuppressive Agents; D013792:Thalidomide