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Erythrodermic psoriasis
Journal of the American Academy of Dermatology
324 Correspondence 2. Moreno-Gimenez Ie, Garcia-Perez A. Dermatofitosis en distintas formas de ictiosis (estudio de 7 casas). Aetas Derma-sif 1982;73:349-52.
of precipitating factors for erythrodermic psoriasis. Awareness ofthe possibility ofa reaction to a drug incases of a dramatic flare of psoriasis has, apart from the theoretic interests, a practical importance because withdrawal of the causative drug is crucial for successful treatment. Sarah Brenner, MD, and Ronni Wolf, MD Department ofDermatology, Ichilov Hospital, 6 Weizman St., Tel-Aviv 64239, Israel
Erythrodermic psoriasis
To the Editor: We enjoyed the review by A. S. Boyd and A. Menter on erythrodermic psoriasis (J AM ACAD DER· MATOL 1989;21:985-91). The article is a valuable and timely contribution to the dermatologic literature. We believe, however, that one aspect of the article requires further consideration. Ofthe 50 patients who were studied by the authors, 29 had concurrent illnesses such as hypertension, atherosc1erotic heart disease, and congestive heart failure. There is no doubt that most ofthem received systemic medications for their disease. We were surprised that the authors did not consider the internal medications among the various factors that may precipitate the erythrodermic episode. Recently we treated several patients with extensive psoriasis, which had been precipitated by internal medications such as captopril, quinidine, and furosemide. We believe that internal drugs should be included in the list
Reply To the Editor: Drs. Brenner and Wolf are certainly correct in suggesting that drugs be included in the list of precipitating factors for erythrodermic psoriasis. In our series of 50 patients we did not believe that medications (e.g., beta blockers) were related in any way to the onset of the erythrodermic episode. However, a careful search for this as a possibility should be considered in all patients with recalcitrant psoriasis. Alan Menter, MD Baylor Psoriasis Center Dallas, Texas
AMERICAN BOARD OF DERMATOLOGY EXAMINATIONS In 1991 the Certifying Examination of the American Board of Dermatology will be held at the Holiday Inn O'Hare Airport in Rosemont, Illinois on Nov. 3 and 4. The deadline for receipt of applications is May 1, 1991. The Dermatopathology Special Qualification Examination will be held in Rosemont, Illinois on Nov. 1, 1991. The deadline for receipt of applications is July 1, 1991. The next Examination for Special Qualification in Dermatological Immunology/ Diagnostic and Laboratory Immunology will be held in Rosemont, Illinois on Nov. 1, 1991. The deadline for receipt of applications is April 1, 1991. For further information about these examinations, please contact: Clarence S. Livingood, MD Executive Director American Board of Dermatology Henry Ford Hospital Detroit, MI 48202
324 Correspondence 2. Moreno-Gimenez Ie, Garcia-Perez A. Dermatofitosis en distintas formas de ictiosis (estudio de 7 casas). Aetas Derma-sif 1982;73:349-52.
of precipitating factors for erythrodermic psoriasis. Awareness ofthe possibility ofa reaction to a drug incases of a dramatic flare of psoriasis has, apart from the theoretic interests, a practical importance because withdrawal of the causative drug is crucial for successful treatment. Sarah Brenner, MD, and Ronni Wolf, MD Department ofDermatology, Ichilov Hospital, 6 Weizman St., Tel-Aviv 64239, Israel
Erythrodermic psoriasis
To the Editor: We enjoyed the review by A. S. Boyd and A. Menter on erythrodermic psoriasis (J AM ACAD DER· MATOL 1989;21:985-91). The article is a valuable and timely contribution to the dermatologic literature. We believe, however, that one aspect of the article requires further consideration. Ofthe 50 patients who were studied by the authors, 29 had concurrent illnesses such as hypertension, atherosc1erotic heart disease, and congestive heart failure. There is no doubt that most ofthem received systemic medications for their disease. We were surprised that the authors did not consider the internal medications among the various factors that may precipitate the erythrodermic episode. Recently we treated several patients with extensive psoriasis, which had been precipitated by internal medications such as captopril, quinidine, and furosemide. We believe that internal drugs should be included in the list
Reply To the Editor: Drs. Brenner and Wolf are certainly correct in suggesting that drugs be included in the list of precipitating factors for erythrodermic psoriasis. In our series of 50 patients we did not believe that medications (e.g., beta blockers) were related in any way to the onset of the erythrodermic episode. However, a careful search for this as a possibility should be considered in all patients with recalcitrant psoriasis. Alan Menter, MD Baylor Psoriasis Center Dallas, Texas
AMERICAN BOARD OF DERMATOLOGY EXAMINATIONS In 1991 the Certifying Examination of the American Board of Dermatology will be held at the Holiday Inn O'Hare Airport in Rosemont, Illinois on Nov. 3 and 4. The deadline for receipt of applications is May 1, 1991. The Dermatopathology Special Qualification Examination will be held in Rosemont, Illinois on Nov. 1, 1991. The deadline for receipt of applications is July 1, 1991. The next Examination for Special Qualification in Dermatological Immunology/ Diagnostic and Laboratory Immunology will be held in Rosemont, Illinois on Nov. 1, 1991. The deadline for receipt of applications is April 1, 1991. For further information about these examinations, please contact: Clarence S. Livingood, MD Executive Director American Board of Dermatology Henry Ford Hospital Detroit, MI 48202