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To the Editor.—
In the treatment of any disorder, the simultaneous use of two different therapies usually does little more than either individually. It is only occasionally that the effect of two different modes of treatment are additive. Yet, such an occurrence may be available in erythropoietic protoporphyria (EPP). Just recently, Mathews-Roth et al (228:1004, 1974) reported sevenfold (median) photoprotection in sunlight in EPP patients using orally administered β-carotene. In 1970 (Br Med J 1:730, 1970), a 15-fold (median) increase in sunlight protection was reported in seven EPP patients using a topically administered dihydroxyacetone and lawsone preparation. Since then, we have treated six additional EPP patients with a stable preparation of dihydroxyacetone and lawsone (Duoshield). The Table summarizes the results.Since β-carotene is taken orally and the dihydroxyacetone and lawsone preparation is used topically, the total photoprotective effect should be additive. Thus, we can approximately double the time these patients
Fusaro RM, Johnson JA. Sunlight Protection for Erythropoietic Protoporphyria Patients. JAMA. 1974;229(11):1420. doi:10.1001/jama.1974.03230490022006
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