Thalidomide treatment for hypertrophic cutaneous lupus erythematosus.
BACKGROUND
In recent years numerous reports have been published regarding satisfactory thalidomide therapy for refractory chronic cutaneous lesions of lupus erythematosus (CCLE); to date, in the literature, there is just one report describing two patients affected by hyperkeratotic CCLE successfully treated with thalidomide.


METHODS
Six patients affected by a hypertrophic/verrucous variant of CCLE were treated with thalidomide during the period October 1999 to December 2002 and their medical records were retrospectively reviewed. The initial dose of thalidomide was 100 mg/die by mouth for all the cases, while the duration of therapy was variable among the patients.


RESULTS
All six patients responded to treatment: two had partial resolution of the lesions and four achieved almost complete clearing of cutaneous disease. Response to treatment was seen in the first month of therapy in all the patients. Follow-up nerve conduction studies were negative but a patient had to discontinue the drug because of neurological problems.


CONCLUSIONS
Our case series confirms the efficacy of a 'low-dose' thalidomide regimen in verrucous/hyperkeratotic CCLE, which is normally unresponsive to conventional treatment; in this setting, thalidomide should be kept in mind as an extremely valid therapeutic option despite the lack of prospective, randomized, double-blind, placebo-controlled studies.
Gambini
D
D
Institute of Dermatological Science, University of Milan, IRCCS, Ospedale Maggiore, 20122 Milan, Italy. danielegambini@hotmail.com
Carrera
C
C
Passoni
E
E
Muratori
S
S
Berti
E
E
Caputo
R
R
D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013792:Thalidomide / Q000627:therapeutic use*
D013792:Thalidomide