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To the Editor.—
This letter is rather difficult to answer. I would agree with their experience using topical methoxsalen and sunlight. This regimen does produce repigmentation, however, most American dermatologists do not use this combination because of the resulting severe blistering reactions frequently seen. Perhaps we cannot control our sunlight as well in the United States as in India. The Blacklite regimen is a compromise—less rapid repigmentation, but with less severe adverse reactions.We did use Blacklite and topical methoxsalen alone, and we noted no repigmentation. We did not compare the effect of sunlight to Blacklite because of the blisters induced by natural ultraviolet light. We are presently studying the effects of topical trioxsalen (Trisoralen) (0.1%) and find that natural ultraviolet light is needed for repigmentation using this weaker formation, but with this agent, blistering has not been a problem.