To the Editor.—
The article entitled "Cornoid Lamella in Pachyonychia Congenita," by Wilkin et al, in the December 1978 Archives (114:1795-1796), aroused our interest because of the association of several manifestations of disordered keratinization, namely, thickened fingernails and toenails, follicular keratotic papules on the elbows and knees, and keratoses and ruptured bullae on the soles, together with a biopsy specimen from a keratotic papule showing a cornoid lamella that was characteristic of porokeratosis of Mibelli. There was no mention of treatment in the case reported.We would like to offer a therapeutic suggestion, one we have found to be of value in several dermatoses characterized by defects in keratinization, such as Darier's disease,1 pityriasis rubra pilaris,2 and acne vulgaris.3 Although we have not had the opportunity of treating either pachyonychia congenita or porokeratosis of Mibelli by this method, the treatment is harmless and might conceivably prove effective.
Ayres S, Mihan R. A Therapeutic Suggestion for Defects in Keratinization. Arch Dermatol. 1979;115(7):817. doi:10.1001/archderm.1979.04010070003005