To the Editor.—
Recurrences of erythrodermic seborrhoic dermatitis (SED) have often warranted the use of systemic corticosteroids.1,2 The difficulties in tapering the corticosteroids, as well as their side effects, are well known.3We report two cases of relapsing SED in long-term corticosteroid therapy, where clearing of the erythroderma and withdrawal of systemic steroids were made possible by concomitant photochemotherapy with psoralens and ultraviolet light A (PUVA).4,5 A third case of recurrence after cessation of systemic steroid was cleared by photochemotherapy, too. Clinical findings are given in the table.On this background, we advocate (1) that PUVA therapy is used as a therapeutic cover during withdrawal of systemic corticosteroids in patientsClinical Findings Finding Patient Duration of seborrhoic dermatitis, yr 12 Duration of systemic steroid therapy, mo 45 12 Cumulative dose of steroid, mg 11,392.5 5,383 4,160 Number of relapses after decrease of steroid dose Duration of treatment with
Dahl KB, Reymann F. Photochemotherapy in Erythrodermic Seborrhoic Dermatitis. Arch Dermatol. 1977;113(9):1295–1296. doi:10.1001/archderm.1977.01640090143030
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