To the Editor.—
In the article "Toxic Doses of Vitamin A for Pityriasis Rubra Pilaris," by Randle et al, in the Archives (1980;116:888-892), a new treatment for pityriasis rubra pilaris (PRP) is advocated. Six patients were given 1 million units of vitamin A daily for five to 14 days, resulting in massive exfoliation and side effects requiring hospitalization. The response was apparently spectacular.We have achieved comparable results both in PRP and Darier's disease through the synergistic action of large but nontoxic doses of vitamins A and E, without any undesirable side effects or need for hospitalization.1 We obtained complete or almost complete control in four patients with PRP and in three of four patients with Darier's disease, administering an average adult daily dose of 800 to 1,600 IU of vitamin E in the form of D-α-tocoferol acetate and 100,000 IU of water-dispersible vitamin A. Response was slower, but
Ayres S, Mihan R, Scribner MD. Further Information on Large Doses of Vitamins. Arch Dermatol. 1981;117(1):2–3. doi:10.1001/archderm.1981.01650010006006
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