To the Editor.—
An interesting contribution to reports on the forms of therapy for dermolytic bullous dermatosis (dystrophic epidermolysis bullosa) was made by Smith and Michener in the Archives (108:254, 1973). They describe the effectiveness of vitamin E treatment of the disease in a controlled study and cite previous references to such treatment.1-3 The authors stated, "In recent years, several authors have suggested that vitamin E (DL-alpha tocopherol) might be useful in the treatment of epidermolysis bullosa."This is likely to cause confusion because it suggests that vitamin E and DL-alpha tocopherol are synonymous. Actually, vitamin E and tocopherol are synonymous, but tocopherol is available in a variety of forms with varying therapeutic effectiveness. Tocopherol has a number of fractions, the alpha fraction of which possesses most of the therapeutic activity. This is demonstrated by the fact that pathological conditions in experimental animals resulting from a vitamin E-deficient diet