Stanozolol in the Treatment of Pityriasis Rubra Pilaris

To the Editor.—  In response to the short report by Pavlidakey et al¹ in the Archives, we, too, were intrigued by the proposal of Finzi et al² that the underlying defect in pityriasis rubra pilaris (PRP) might be a deficiency of retinol binding protein, resulting in inadequate transport of vitamin A to the skin. Their success in treating three patients with stanozolol,³ an anabolic steroid used to elevate the levels of retinol binding protein, was also of great interest. Our experience in using stanozolol in the treatment of PRP, however, has been less encouraging.In an attempt to duplicate the results of Finzi et al, we gathered a series of five patients with classic adult PRP, diagnosed on clinical grounds with supportive histopathology. As in the case reported by Pavlidakey et al, baseline retinol binding protein levels were within the normal range. Nevertheless, we proceeded with a