Thalidomide and discoid lupus erythematosus: case series and review of literature

Article Details

Authors
Giovanna Malara, Chiara Verduci, Maria Altomonte, Maria Cuzzola, Caterina Trifirò, Cristina Politi, Giovanni Tripepi

Article Type
Case Series

DOI
10.7573/dic.2021-9-8

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Abstract

Background: The anti-inflammatory drug, thalidomide, is often administered off-label especially in dermatology patients with diseases refractory to different medications. The drug’s mechanism of action is not well understood but clinical evidence suggests an immunomodulatory function. Although this drug is a useful tool for several dermatoses, there are associations between its use and neurotoxic and teratogenic side effects. Consequently, it is reserved only for severe and refractory cases.

Methods: Herein, we present a review about thalidomide focusing on its application in dermatology, particularly on discoid lupus erythematosus (DLE) treatment. We analyzed four cases of people who had a regression of DLE with a dosage of 50 mg thalidomide. Patients were followed to determine the conditions treated with thalidomide, dosage, efficacy, duration of treatment, side effects, adverse events and follow-up. A low dose of 50 mg/day induced a notable and rapid improvement within 1–2 months of treatment and no side effects have been reported so far.

Results: We report four cases of DLE treated previously with the most common immunomodulatory agents with no results and finally successfully treated with thalidomide. In all four patients, despite a low dose of 50 mg/day, a notable and rapid improvement was obtained within a few months of treatment with no side effects.

Conclusions: Notwithstanding the small cohort size, our experience confirms the efficacy of thalidomide for the treatment of DLE.

Keywords: cutaneous lupus erythematosus, discoid lupus erythematosus, thalidomide.

Citation: Malara G, Verduci C, Altomonte M, Cuzzola M, Trifirò C, Politi C, Tripepi G. Thalidomide and discoid lupus erythematosus: case series and review of literature. Drugs Context. 2022;11:2021-9-8. https://doi.org/10.7573/dic.2021-9-8

Contributions: All authors contributed equally to the preparation of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/02/dic.2021-9-8-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2022 Malara G, Verduci C, Altomonte M, Cuzzola M, Trifirò C, Politi C, Tripepi G. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0, which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 Malara G, Verduci C, Altomonte M, Cuzzola M, Trifirò C, Politi C, Tripepi G. https://doi.org/10.7573/dic.2021-9-8. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/thalidomide-and-discoid-lupus-erythematosus-case-series-and-review-of-literature

Correspondence: Chiara Verduci, Pharmacology Department, Magna Graecia University, Catanzaro, Italy. Email: verducichiara@icloud.com

Provenance: Submitted; externally peer reviewed.

Submitted: 7 December 2021; Accepted: 3 February 2022; Publication date: 16 March 2022.

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