Thalidomide as Elective Treatment in Persitent Erythema Mutliforme ; Report of Two Cases
February 2003 | Volume 2 | Issue 1 | Original Article | 40 | Copyright © February 2003
Julian S. Conejo-Mir, MD; Susana del Canto, MD; Miguel Angel Muñoz, MD; Lourdes RodrÃguez-Freire, MD; Amalia Serrano, MD; Carlos Hernandez, MD and Agueda Pulpillo, MD
Abstract
Recurrent erythema multiforme is a rare disorder, clinically characterized by symmetrically distributed, erythematous, and
bullous skin and mucous lesions, mainly precipitated by a preceding herpes simplex infection. In rare cases, EM presents
continuous or persistent relapses, and has been related to an Epstein-Barr virus infection. We report 2 cases of severe, persistent
erythema multiforme, treated with thalidomide, with complete disease suppression in both cases. Thalidomide
induces immunomodulator, anti-inflammatory, and anti-angiogenic effects, and may be considered as the elective treatment
of this rare variety of erythema multiforme. However, in order to avoid neuropathic side effects, patients under
thalidomide therapy should be monitored every 6 months with nerve conduction studies while taking the drug. 
