Vanderveen's and Ellis' letter was mailed immediately after the publication of their article in the September 1982 Archives. The more detailed case story was reported later by my co-workers in Dermatologica. Unexpectedly, the latter appeared much earlier than the letter.Etretinate was given to our patient in combination with methotrexate from Nov 21,1980 to March 26,1981. Unfortunately, my letter to the editor did not state clearly the starting date, which according to the text could be interpreted as being in April. This was not the case.Four months may not be regarded as "short-term" therapy, but the intention was that it should have been. Due to a flare of the patient's psoriasis, the methotrexate dosage was never reduced to more than 7.5 mg/wk until her hepatitis occurred, when therapy with both drugs was discontinued. As stated, etretinate alone could have been responsible for the liver damage. A few
Zachariae H. Methotrexate and Etretinate in the Treatment of Psoriasis-Reply. Arch Dermatol. 1984;120(12):1556. doi:10.1001/archderm.1984.01650480017005
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