The Authors present a case of a 17 year-old patient with a 7-year history of Crohn’s disease which had been controlled with azathioprine. The patient was admitted to our Clinic because he presented painful nodules on the leg. At the time of admission abdominal pain was occasionally present. On examination he presented tender, indurate, erytematous nodules on the extensor aspects of the left leg. Skin biopsy of a representative nodule revealed lobular panniculitis. Colonoscopy showed active mucosal lesions and ileal substenosis. The patient was included in a randomized controlled double-blind multicentric study with thalidomide. The patient received thalidomide from the beginning and in six weeks the skin nodules responded well to the treatment.