Sequential combined therapy with thaiidomide and narrow-band (tl01) uvb in the treatment of prurigo nodularis

Background: Prurigo nodularis (PN) is a chronic disease of which treatment choices are limited. Among them, thaiidomide and phototherapy have been used with satisfactory results. Unfortunately, the possibility of side effects limits their use. Objective: To evaluate the efficacy of a sequential combined treatment with thaiidomide and ultraviolet B (UVB) therapy in order to minimize side effects and, thus, making possible a long-term treatment. Methods: A prospective open trial combining thaiidomide as initial therapy followed by narrow-band UVB (TL01) irradiation until complete or almost complete remission of the disease was achieved. Results: An excellent response was obtained after an average of 12 weeks of thaiidomide therapy and 32 UVB courses. Conclusions: Sequential combined therapy with thaiidomide and narrow-band UVB therapy could improve the management of prurigo nodularis with minimal side effects, although it should probably be reserved to men and women over 50 years of age. © 1997 S. Karger AG, Basel.