Efficacy and safety of thalidomide in treatment of prurigo nodularis
Keywords:
Thalidomide, pruritus, prurigo nodularisAbstract
Objective To determine the efficacy and safety of thalidomide in treatment of idiopathic prurigo nodularis. Methods A total of 12 patients were enrolled in the study. Patients of child bearing potential and those with active systemic disease were excluded. All the patients had the histopathological confirmation of diagnosis. Patients were given 100mg/day of thalidomide for a period of three months. Follow up visit was every one month and therapy was stopped at three months. Patients were again evaluated for relapse two months after stopping the treatment. Results 7 (58.3%) patients had successful response to the treatment. 3 (25%) patients had a partial response and 2 (16.7%) had unsuccessful treatment. Conclusion Thalidomide is safe and effective treatment option for idiopathic recalcitrant prurigo nodularis.References
Hardaway WA. Case of multiple tumor of the skin accompanied by intense pruritus. Arch Dermatol. 1880;6:129-32.
Hyde JN. Prurigo nodularis. In: Hyde JN, Montgomery FH, eds. A Practical Treatise on Diseases of the Skin for the Use of Students and Practitioners. Philadelphia: Lea and Febiger; 1909. P. 174-5.
Accioly-Filho JW, Nogueira A, Ramos-e-Silva M. Prurigo nodularis of Hyde: an update. J Eur Acad Dermatol Venereol. 2000;14:75-82.
Alfadley A, Al-Hawsawi K, Thestrup-Pedersen K, Al-Aboud K. Treatment of prurigo nodularis with thalidomide: a case report and review of the literature. Int J Dermatol. 2003;42:372-5.
Jorizzo JL, Gatti S, Smith EB. Prurigo: a clinical review. J Am Acad Dermatol. 1981;4:723-8.
Radomsky CL, Levine N. Thalidomide. Dermatol Clin. 2001;19:87-103.
Sampaio EP, Sarno EN, Galilly R, Cohn ZA, Kaplan G. Thalidomide selectively inhibits tumor necrosis factor-α production by stimulated human monocytes. J Exp Med. 1991;173:699-703.
Winkelmann RK, Connolly SM, Doyle JA, Padilha-Goncalves A. Thalidomide treatment of prurigo nodularis. Acta Derm Venereol. 1984;64:412-7.
Radomsky CL, Levine N. Thalidomide. Dermatol Clin. 2001;19:87-103.
Calderon P, Anzilotti M, Phelps R. Thalidomide in dermatology. New indications for an old drug. Int J Dermatol. 1997;36:881-7.
Doherty SD, Hsu S. A case series of 48 patients treated with thalidomide. J Drugs Dermatol. 2008;7:769-73.
Orlando A, Renna S, Cottone M. Prurigo nodularis of Hyde treated with low-dose thalidomide. Eur Rev Med Pharmacol Sci. 2009;13:141-5.
Lan CC, Lin CL, Wu CS, Chai CY, Chen WT, Chen GS. Treatment of idiopathic prurigo nodularis in Taiwanese patients with low-dose thalidomide. J Dermatol. 2007;34:237-42.
Stirling DI. Thalidomide and its impact in dermatology. Semin Cutan Med Surg. 1998;17:231-42.
Wulff CH, Høyer H, Asboe-Hansen G, Brodthagen H. Development of polyneuropathy during thalidomide therapy. Br J Dermatol. 1985;112:475-80.
Sheskin J, Gorodetzky R, Loewinger E, Weinreb A. In vivo measurements of iron, copper and zinc in the skin of prurigo nodularis patients treated with thalidomide. Dermatologica. 1981;162:86-90.
Crouch RB, Foley PA, Jonathan CH, Baker CS. Thalidomide experience of a major Australian teaching hospital. Australas J Dermatol. 2002;43;278-84.
Aronson IK, Yu R, West DP, Van den Broek H, Antel J. Thalidomide-induced peripheral neuropathy. Effect of serum factor on nerve cultures. Arch Dermatol. 1984;120:1466-70.
