Deep Venous Thrombosis Associated with Thalidomide use in a Case of Steroid Dependent Erythema Nodosum Leprosum-a Management Conundrum

Introduction: Thalidomide, previously banned owing to the issues of teratogenicity is being used and tested for a variety of dermatological and non dermatological conditions. The drug has been approved for the management of erythema nodosum leprosum [ENL] and multiple myeloma [MM]. The drug is commonly known to produce adverse effects like peripheral neuropathy and constipation. Deep vein thrombosis [DVT] is one of the serious adverse effects seen with thalidomide use, especially in malignancies and is relatively uncommon in non cancer settings like ENL. Method: Here we report a case of DVT occurring after 8 months of use of thalidomide in a young patient of 22 years age suffering from ENL. Result: The case highlights the problems faced in the management of refractory ENL and the treatment of DVT in the setting of multiple drug interactions and financial constraints. Conclusion: New guidelines are required regarding the prophylaxis and management of DVT associated with thalidomide use in non-malignant conditions.