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To the Editor.—
Atrophy is a prominent side-effect of injecting potent corticosteroids into skin. Prolonged topical application too may lead to thinning, striae, and purpura. These manifestations are mainly consequences of the ability of corticosteroids to inhibit collagen synthesis, abetted by an indirect collagenolytic mechanism. The loss of collagen weakens the fibrous scaffolding of the dermis, and the tissue becomes fragile and mechanically unfit.In solar elastosis there is a massive accumulation of elastic fibers that in the end stages may almost completely replace collagen histologically.The question arise whether intradermal injection of corticosteroids has an elastolytic effect. The removal of excess elastic tissue by this means might have interesting therapeutic possibilities in the treatment of primary and secondary elastosis.Three elderly subjects with prominent solar elastosis of the back of the neck received four weekly injections of 0.1 ml of triamcinolone acetonide (25 mg/ml) into the same site. In