We appreciate the comments by Ries and Schiffmann regarding our editorial.1 They are correct in stating that the use of surrogate markers in Fabry disease (FD) may produce some controversy.
In respect to angiokeratomas (AK) as a possible biomarker for disease progression as well as effect of treatment in FD, several aspects have to be taken into consideration. These include the following:
Möhrenschlager M, Henkel V, Ring J. Fabry Disease: Angiokeratoma, Biomarker, and the Effect of Enzyme Replacement Therapy on Kidney Function—Reply. Arch Dermatol. 2005;141(7):904-906. doi:10.1001/archderm.141.7.905