To the Editor.—
A need has arisen for multiple cholesterol lowering agents because of problems with the side effects of drug therapy and because of the usefulness of combination therapy in lowering cholesterol levels.1 The hypercholesterolemic drugs tripanol, 20,25-diazacholesterol, and gemfibrozil can induce hyperkeratosis, causing scaling disorders, and can, sometimes, cause psoriasis to flare.2 Hairless male mice painted with the hypercholesterolemic drug lovastatin develop epidermal hyperplasia, erythema, scaling, and increased DNA synthesis, leading to the inference that this drug therapy might cause psoriasis to flare.3 It is somewhat comforting that less than 5% of an oral dose of this drug enters the circulation systemically, but the lowest toxic dose is unknown.1,3,4 The manufacturer (Merck Sharp & Dohme, Rahway, NJ), on the other hand, has anecdotal evidence that the condition of some psoriatic subjects improves when this drug is administered. To rule out the likelihood that use
Aronson PJ, Friedman DB. Pharmacologic Doses of Lovastatin Do Not Predictably Affect the Course of Psoriasis. Arch Dermatol. 1992;128(1):124. doi:10.1001/archderm.1992.01680110138028
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