Mid-dermal elastolysis

Volume 27 Number 5, Part 1 November 1992

Correspondence

ready documented. As reported in his book, Dr. Mohs 1 treated five BCCs of the scrotum, yielding an overall incidence of 0.065% (N = 7674).We believe that there is a greater risk of metastatic BCC when the primary BCC is located on the scrotum.

Jacob S. Lo, MD Stephen iV. Snow, MD The Mohs Surgery Clinic University of Wisconsin Hospital 2880 University Ave. Madison, WI 53705

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REFERENCES 1. Pennington DG, Waner M, Knox A. Photodynamic therapy for multiple skin cancers. Plast Reconstr Surg 1988;82:106771. 2. Robinson P J, Carruth JAS, Fairris GM. Photodynamie therapy: a better treatment for widespread Bowen's disease. Br J Dermatol 1988;119:59-61. 3. McCaughan JS, Guy .IT, Hicks W, et al. Photodynamic therapy for cutaneous and subcutaneous malignant neoplasms. Arch Surg 1989;124:211-6. 4. Gross DJ, Warier M, Schosser R_H, et al. Squamous cell carcinoma of the lower lip involvinga large cutaneous surface. Arch Dermatol 1990;126:1148-50.

REFERENCE

Mid-dermal elastalysis

1. Mohs FE. Chemosurgery: microscopioaltycontrolled surgery for skin cancer. Springfield, Ill: Charles C Thomas, 1978.

To the Editor." I read with interest the recent article on mid-dermal elastolysis by Kim and Su (J AM AeAD DERMATOL1992;26:169-73). I was surprised to note that an article of mine (published in early 1990) documenting two "classic" cases of mid-dermal elastolysis was not ineluded in their extensive bibliography.1 Since the "accepted for publication" date for Dr. Kim's article was July 1991, I daresay that there was plenty of time during revision and "galley proofing" of their article for the two cases I reported to have been added to this "review of the literature."

Biology of cutaneous squamous cell carcinoma To the Editor: The recent review of squamous cell carcinoma (SCC) by Kwa et al. (J AM ACAD DERMATOL 1992;26:1-26) is comprehensive and well researched. In general, it provides insight into the biologic behavior and treatment of this tumor. However, we take exception with the generally negative comments presented concerning the use of photodynamic therapy (PDT) in the treatment of cutaneous SCC. A study in which one of us (M. W.) participated was used to support the overall position that PDT shows little potential as a therapeutic modality for SCC. 1It should be known that the poor results of this particular study could be attributed to the use of too low laser energy density and that other investigators have had considerably more encouraging results in the treatment of SCC with PDT. 2, 3 Such studies, 2, 3 as well as single case reports4 in which PDT was used to treat in situ and invasive SCC, have yielded, good results. Indeed, we have learned from our earlier experiences with PDT. David J. Gross, MD, a and Milton Waner, MD, b Kaiser Permanente, Tucker, Georgia,a and the Department of Otolaryngology and Head & Neck Surgery, University of Arkansas for Medical Sciences Little Rock, Arkansas b

Robert L Rudolph, MD 1134 Penn Ave. Wyomissing, PA 19610

REFERENCE 1. Rudolph RI. Mid-dermal elastolysis. J AM ACADDERMATOL 1990;22:203-6.

Reply To the Editor." When we first searched the literature, the excellent article by Dr. Rudolph on mid-dermal elastolysis had not appeared. We became aware of this article after we submitted our paper to the JOURNAL. W e intended to include Dr. Rudolph's paper at the galleyproof stage but forgot to do so. it was our mistake, and we apologize for it. ,long Min Kim, MD, and W.. P. Daniel Su, M D Department of Dermatology Mayo Clinic and Mayo Foundation Rochester, M N 55905