Thalidomide use in dermatological diseases in Brazil

Abstract This prospective study on the use of thalidomide in dermatological diseases was conducted at the Dermatology Outpatient Clinic of the ABC Medical School and its main goal was to describe and analyze the epidemiological profile of patients using the drug. Given the diversity of diagnoses made in this reference service in Dermatology in Brazil, this study evaluated the variety of dermatological diseases whose improvement is associated with the use of thalidomide, also describing their side effects when reported. Of the 29 patients who used thalidomide for dermatological diseases, 89.6% (26 patients) reported improvement of the lesions and symptoms associated with the dermatological diagnosis, 13.7% (4 patients) reported side effects resulting from the use of the medication and requested suspension of thalidomide. For one of the patients diagnosed with dimorphic Virchowian leprosy and recalcitrant erythema nodosum, the diagnosis of reactional neuritis or neuropathic pain resulting from the use of thalidomide was questioned, and they chose to discontinue the medication. Despite the significant improvement after the use of thalidomide in dermatological diseases in patients of the Dermatology Outpatient Clinic of ABC Medical School, it is worth highlighting that, due to the known adverse effects, particularly teratogenicity and neurotoxicity, there is still much controversy surrounding the use of this drug. In this sense, its clinical use must be carefully evaluated and carefully considered regarding the risk-benefit ratio, especially in cases of patients with prior neuropathy and in women of childbearing age.