Disease Relapses

Recurrences of the skin lesions are frequent when thalidomide is withdrawn. Most of the studies report that in approximately 70% of patients the skin lesions flare between 2 weeks and 3 months after discontinuing use of the drug (Knop et al. 1983, Kyriakis et al. 2000, Stevens et al. 1997). In other series (Atra and Sato 1993), the rate of recurrence is lower (35%), with milder symptoms than those before treatment (Kyriakis et al. 2000). Thalidomide probably exerts its immunomodulatory properties only while administered. The introduction of other drugs, such as antimalarials and low-dose steroids, at the time of thalidomide dose reduction might reduce the risk of relapses at complete withdrawal of thalidomide.

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