Dermatology Department, Hospital General de México, Mexico, Mexico.
Australas J Dermatol. 2021 Aug;62(3):375-379. doi: 10.1111/ajd.13571. Epub 2021 Mar 17.
Thalidomide is a second-line treatment for discoid lupus erythematosus (DLE). The efficacy of this treatment, the minimum effective doses, and safety is poorly documented in the literature. The aim of the study was to determine the efficacy and tolerance of thalidomide as first or second line of therapy for discoid lupus erythematosus. We present a retrospective single-centre study of 68 patients with DLE treated with thalidomide from 2003 to 2019. The inclusion criteria were the presence of clinical lesions suggestive of DLE, confirmed by histological examination and direct immunofluorescence. The mean age at diagnosis was 37.45 years (range 18-65 years). Thalidomide was started an average of 2.25 years after the diagnosis of DLE, as second-line therapy in 85% of the cases (58 patients), and as first-line therapy in 10 patients (15%). Fifty-six patients improved with thalidomide (82%), 39 cases achieved complete remission and 17 partial remissions. The mean duration of follow-up with thalidomide was 8.4 months (range 3-25 months). Five patients discontinued thalidomide due to adverse events. The most frequent side effect was headache (23.5%). Thalidomide is effective and safe in DLE patients as first or second-line treatment with a good safety profile.
沙利度胺是盘状红斑狼疮（DLE）的二线治疗药物。该治疗方法的疗效、最小有效剂量和安全性在文献中记录甚少。本研究旨在确定沙利度胺作为盘状红斑狼疮一线或二线治疗的疗效和耐受性。我们回顾性分析了 2003 年至 2019 年期间在我院接受沙利度胺治疗的 68 例 DLE 患者。纳入标准为存在临床疑似 DLE 病变，经组织学检查和直接免疫荧光证实。诊断时的平均年龄为 37.45 岁（18-65 岁）。沙利度胺平均在 DLE 诊断后 2.25 年开始使用，85%（58 例）的患者为二线治疗，10 例（15%）为一线治疗。56 例患者的沙利度胺治疗有效（82%），39 例完全缓解，17 例部分缓解。沙利度胺的平均随访时间为 8.4 个月（3-25 个月）。5 例患者因不良反应停用沙利度胺。最常见的不良反应是头痛（23.5%）。沙利度胺作为 DLE 患者的一线或二线治疗药物，疗效确切且安全，具有良好的安全性。
