To the Editor.
—We have read with interest the article "Treatment of Systemic Sclerosis With Extracorporeal Photochemotherapy" by Rook and coworkers1 in the March 1992 issue of the Archives. By no means do we question their results, but we find that we are obliged to express some words of caution, as it is our experience that patients with the severe progressive form of the disease may not all be sufficiently controlled by photopheresis alone. This, at least, applies to patients who have more pronounced symptoms from organs other than the skin.For 5 to 8 months we have used photopheresis to treat eight patients with severe systemic sclerosis. We planned to treat all patients for at least 8 months, but, due to severe exacerbations, it was necessary to give additional immunosuppressive therapy to four patients. Two of these patients, together with another patient, wanted to discontinue photopheresis after 5
Zachariae H, Bjerring P, Heickendorff L, Møller B, Wallevik K. Photopheresis and Systemic Sclerosis. Arch Dermatol. 1992;128(12):1651-1652. doi:10.1001/archderm.1992.04530010087019