Thalidomide in the Treatment of Recurrent, Necrotic, and Giant Mucocutaneous Aphthae and Aphthosis

To the Editor.— The treatment of recurrent and necrotic mucocutaneous aphthae is usually unsatisfactory. In six cases (men aged 30 to 39), we obtained an excellent result with thalidomide. The cutaneous symptoms in five of the patients consisted of large, deep, necrotic, painful ulcerations in the mouth and on the scrotum, and pustular lesions scattered on different parts of the body. The sixth patient had giant, deep, necrotic, mutilating lesions in the mouth, as in so-called periadenitis mucosa necrotica recurrens; he had not been free of these lesions for the past year and was having enormous difficulties with his nutrition. One of the patients had had uveitis, orchitis, and epididymitis (inactive during the treatment with thalidomide), and two had active arthritis at the time of treatment. The daily administration of 100 mg of thalidomide gave us spectacularly good results. On the second or third day, the aphthae were painless and