Thalidomide in refractory vulvar ulcerations associated with Crohn's disease.
We report a case of recurrent vulvar ulcerations developed on vegetations associated with Crohn's disease. Lesions responded to low-dose thalidomide treatment. A biopsy revealed a neutrophilic infiltrate with rare giant cells. Vulvar manifestations were consistent with metastatic Crohn's disease or with a reactive neutrophilic dermatitis. Thalidomide reduces the activity of tumor necrosis factor (TNF) alpha by accelerating the degradation of its mRNA. Nowadays, it has become a promising drug in a broad variety of disorders in which TNF-alpha seems to play a pivotal role, including inflammatory bowel diseases. This is the first case report presenting the efficacy of thalidomide in the treatment of vulvar involvement in Crohn's disease.
Kolivras
Athanassios
A
Department of Dermatology, University Hospital Saint-Pierre and Brugmann, Brussels, Belgium. kolivrasathangr@hotmail.com
De Maubeuge
Josiane
J
André
Josette
J
Song
Micheline
M
D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D013792:Thalidomide / Q000627:therapeutic use*; D016896:Treatment Outcome; D014456:Ulcer / Q000188:drug therapy* / Q000209:etiology; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000209:etiology
D007166:Immunosuppressive Agents; D013792:Thalidomide