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Induction Therapy with Thalidomide for Recalcitrant Subacute Lupus Erythematosus

  • Author(s): Costner, Melissa I.
  • et al.
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Induction Therapy with Thalidomide for Recalcitrant Subacute Lupus Erythematosus
Melissa I. Costner MD1
Dermatology Online Journal 7(1):24A

1. Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas

Thalidomide has been used effectively in the treatment of cutaneous lupus erythematosus for several decades. However, its side effects profile and prescribing restrictions make thalidomide difficult to take for an extended period. To circumvent this problem, we employed a strategy of induction therapy with thalidomide followed by its withdrawal after clearing of skin lesions. Patients were then maintained on either single-agent or combination anitmalarials. We report our experience with six patients who had widespread, recalcitrant, subacute cutaneous lupus erythematosus and were treated using this strategy. Each patient cleared in 2-4 weeks with doses of 100-150 mg qhs, and remained clear or nearly clear on maintenance antimalarial therapy. Thus, thalidomide may be used in a fashion similar to that employed with oral corticosteroids: an initial burst followed by a rapid taper while concurrently introducing a "thalidomide-sparing" agent.

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