[Should thalidomide be rehabilitated?]. / Faut-il réhabiliter la thalidomide?

Thalidomide (alpha-N-phtalimido-glutarimide) was withdrawn from sale in 1961 since it was held responsible for the birth of hundreds of phocomelus children. Despite this teratogenic potential, thalidomide remains a useful tool in the treatment of erythema nodosum leprosum, as well as in discoid lupus erythematosus when antimalarial drugs are ineffective or contraindicated. In addition, good results have been reported in several diseases such as actinic prurigo, polymorphous light eruption, Behçet syndrome, Weber-Christian disease, prurigo nodularis, pyoderma gangrenosum and ulcerative colitis. The mechanism of action is under debate but it is likely that thalidomide has immunomodulating properties by controlling T-suppressor lymphocytes, and anti-inflammatory effects, particularly an inhibition of neutrophil chemotaxis. Several attempts at synthesis of effective thalidomide derivatives devoid of teratogenic effects are ongoing.

Small bowel deposition of crystals associated with the use of clofazimine (Lamprene) in the treatment of prurigo nodularis.

A 46-year-old woman with widespread prurigo nodularis was treated with 300 mg clofazimine a day for six months. Ten months after stopping the drug she complained of weight loss and gastrointestinal side effects which were shortly improved by a gluten-free diet, but relapsed one year later. At laparotomy, all tissues were stained bright orange-yellow, and histological examination showed crystals deposited in the chorion of intestinal villi and in the mesenteric lymph nodes.

[Exudative enteropathy caused by clofazimine: apropos of a case]. / Entéropathie exsudative à la clofazimine: à propos d'une observation.

The authors report a case of a forty-six year old woman suffering from generalized prurigo nodularis. This dermatosis was associated with a cellular immunodeficiency; therefore a clofazimine therapy 300 mg/a day was instituted for six months. Ten months after the cessation of the clofazimine therapy, there appeared a malabsorption syndrome that was temporarily improved by gluten--free diet the real etiology was only ascertained during laparotomy, when masses of crystals in the small intestine mucosa as well as in mesenteric lymph nodes were observed. Therefore when it is necessary to prescribe clofazimine to take advantage of become its immunoregulating properties, it must always become in mind that an intestinal complication may ensue: this is well recognized in articles appearing in journals devoted to leprosy.