To the Editor.—
I was interested to read the recent article in the Archives1 on the possible role of "Ketotifen in Neurofibromatosis." While admiring the ingenuity of Dr Riccardi's approach in attempting to medically treat this as yet untreatable disease, I have reservations about the claim that ketotifen therapy has been shown to decrease skin mast-cell histamine release.This may well have been demonstrated for mast cells in vitro, in animal studies, and in human bronchial mucosa, but there has so far been no convincing evidence that this is so in living human skin.As the rationale for using ketotifen is based on the assumption that it stabilizes human skin mast cells, it is well worth examining the evidence for this, namely the study of Huston et al2 that is cited by Dr Riccardi.In brief, three patients were studied: one with idiopathic cold urticaria, one with dermographism,
Krause L. Ketotifen and Neurofibromatosis. Arch Dermatol. 1988;124(5):651–652. doi:10.1001/archderm.1988.01670050009003
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