Vitamin E Treatment of Dermolytic Bullous Dermatoses

To the Editor.— I read, with interest, the paper by Michaelson et al on vitamin E treatment of epidermolysis bullosa ( Arch Dermatol 109:67, 1974). They base their results on the premise that increased collagenase activity is the cause of this disorder, but did not show clinical photographs of their patients before and after therapy. From a study of the photographs, we could perhaps obtain the correct diagnosis of the three patients. I am studying epidermal neoplasms associated with autosomal recessive epidermolysis bullosa dystrophica and have written all over the world for information regarding such cases. I have received many reports of negative results of vitamin E therapy, without asking for this information. I saw one of the first patients alledged to have the dystropic type of epidermolysis bullosa who in reality had the nondystrophic Weber-Cockayne type of epidermolysis bullosa. I think that the work by Lazarus ( J Invest Dermatol 58:242,