Thalidomide
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Thalidomide Polyneuropathy: case report A 21-year-old man developed polyneuropathy after starting thalidomide for poorly controlled pruritus. The man’s medical history was notable for prurigo nodularis and intractable atopic dermatitis (diagnosed in childhood). Since he had responded poorly to standard therapies, low-dose thalidomide was started to provide relief of itching. After 4 weeks’ therapy with thalidomide 50mg twice daily and concomitant cetirizine, he reported an improvement in his pruritus; his score on a 10-point visual analogue scale decreased from 10 to 7. After a further 6 weeks’ therapy, his condition had resolved and thalidomide was stopped; at this time, he had no signs of peripheral neuropathy. Eight weeks later, his atopic dermatitis and pruritus recurred and thalidomide 100 mg/day was restarted. Again, his pruritus had improved after 2 weeks. However, after 4 weeks’ therapy he experienced paraesthesia in his hands and feet. While a physical examination was unremarkable, the findings of nerve-conduction studies were indicative of a sensory axonal polyneuropathy. Thalidomide was discontinued and the man’s paraesthesia had resolved 6 weeks later, confirmed by a follow-up nerve-conduction velocity test. At follow-up 1 year later, he reported only occasional pruritus. Lin CL, et al. Thalidomide-induced polyneuropathy: friend or foe relief of itch? Clinical and Experimental Dermatology 34: e379-e380, No. 7, Oct 2009 801158059 Taiwan
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Reactions 16 Jan 2010 No. 1284
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