LAUSR

Thalidomide is an immunomodulatory drug which has demonstrated success across several refractory dermatological conditions. Its mechanism remains poorly understood and is uncommonly prescribed in the field of dermatology, usually as a last-line therapeutic option. Historically, there has been hesitation limiting its use, attributed to its significant adverse effect profile. Drug survival is a useful indicator of the viability of a drug taking into account effectiveness, tolerability and safety. Thalidomide’s clinical response and side effect profile are highly variable and difficult to predict. We present an experience of using thalidomide in 28 patients with a range of dermatoses recalcitrant to conventional treatments. Patient’s data were retrospectively analysed from a large metropolitan hospital – 15 females and 8 males. There were four patients with actinic prurigo (17%), seven patients with cutaneous lupus erythematosus (30%), eight patients with prurigo nodularis (35%) and one patient each (4%) of the Behcet disease, hydroa vacciniforme, vasculitis and a papular pruritic eruption with no formal histopathological diagnosis (Table 1). Patients received starting doses between 50 and 100 mg. The most pertinent findings from our data demonstrate