THE CUTTING EDGE: CHALLENGES IN MEDICAL AND SURGICAL THERAPIES SECTION EDITOR: EDWARD W. COWEN, MD, MHSc; ASSISTANT SECTION EDITORS: MURAD ALAM, MD; RUTH ANN VLEUGELS, MD Treatment of Refractory Prurigo Nodularis With Lenalidomide Holly Kanavy, DO; Jennifer Bahner, MD; Neil J. Korman, MD, PhD; Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio Prurigo nodularis is an intensely pruritic disorder in which ter 18 months of therapy, which necessitated discon- chronic scratching and rubbing lead to the formation of tinuation of thalidomide. Other therapies used in- eroded and excoriated skin nodules that may become gen- cluded capsaicin cream, oral naltrexone (50 mg/d) for 2 eralized. Therapy for prurigo nodularis is notoriously dif- months, minocycline (100 mg twice daily) for 4 months, ficult, and relief of pruritus and clearing of the skin le- and gabapentin (600 mg 3 times daily) for 3 months, none sions is exceedingly difficult to achieve. of which led to any improvement. In addition, owing to the availability of sample medication, we treated her with a 12-week course of intramuscular alefacept (15 mg/ REPORT OF A CASE wk), a 12-week course of subcutaneous etanercept (50 mg twice weekly), and intralesional alefacept (10 mg/ A 45-year-old
JAMA Dermatology – American Medical Association
Published: Jul 1, 2012
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