THALIDOMIDES EFFECTIVENESS IN ERYTHEMA-NODOSUM LEPROSUM IS ASSOCIATEDWITH A DECREASE IN CD4-BLOOD( CELLS IN THE PERIPHERAL)

Thalidomide is well documented as being an effective drug in the treat ment of erythema nodosum leprosum (ENL). The mechanism of action of th alidomide in ENL as well as the pathogenesis of ENL are yet to be full y determined. Lepromatous leprosy patients experiencing ENL have been reported to have an increase in the ratio of CD4+ to CD8+ cells in the ir blood and ENL skin lesions. Thalidomide has been shown to cause a d ecrease in the ratio of CD4+ to CD8+ lymphocytes in the blood of healt hy males. This decrease was due to a significant reduction in the numb ers of CD4+ lymphocytes and an apparent increase in the numbers of CD8 + lymphocytes. In this study, thalidomide's effectiveness in halting c hronic ENL and arresting a relapse into ENL was consistently associate d with a decrease in the numbers of CD4+ lymphocytes in the blood of 2 male lepromatous leprosy patients.