Clinical Experience

Although thalidomide is well known to be an effective drug for the various manifestations of cutaneous lupus, it is not widely used to treat these disorders because of its serious side effects and because it is difficult to obtain. Probably for these reasons, there are no randomized, controlled trials proving its efficacy. The available data in the literature come from a few series of patients, which show agreement regarding the good response to treatment but major differences when optimal dose, safety, and relapse rate are analyzed. Table 28.1 shows the results of the main published series. Thalidomide was used to treat DLE in the first large series published almost 20 years ago (Knop et al. 1983). Further series published in the past decade (Atra and Sato 1993, Duong et al. 1999, Kyriakis et al. 2000, Ordi et al. 2000, Sato et al. 1998, Stevens et al. 1997) also included patients with SCLE and SLE with severe cutaneous features.

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