Thalidomide induced deep venous thrombosis in a case of steroid dependent erythema nodosum leprosum- a management conundrum

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 ENL and Multiple myeloma. 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. Here we report a case of DVT induced after 8 months of use of thalidomide in a young patient of 22 years age suffering from ENL. The case also 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.