To the Editor.—
While the clinical manifestations of psoriasis are epidermal, ie, scales, erythema reflects a dermal component. Currently, however, the importance of the dermis, either as an integral part of the dermoepidermal unit or as site of primary stimuli for epidermal change, is overshadowed by attention directed at epidermal events.Previous work1 has indicated that the epidermal response can indeed be modified by dermal changes over limited periods of observation. Recently, we had the opportunity to observe a patient on whom electrodesication procedures affecting the dermis, performed nine years earlier, imposed restraints on lesion manifestations that persisted over those years. The observations we report provide a basis to reflect once more on the nature of this puzzling disease.
Report of a Case
A 44-year old man who has had extensive psoriasis since 1948, was included in a series of studies in 1964 during which one of us electrodesicated
Grekin DA, Van Scott EJ. Dermal Role and Controls in Psoriasis. Arch Dermatol. 1973;108(3):425. doi:10.1001/archderm.1973.01620240071028