Late-onset neurofibromas developed in a patient with psoriasis vulgaris during PUVA treatment

To the Editor.— Neurofibromatosis is a relatively common autosomal-dominant trait. The typical case is characterized by the presence of multiple cafe au lait spots and soft fibrous tumors arising from nerve sheaths that usually develop during childhood or adolescence. Aside from typical cases, this disease has a variable expression. 1 Recently we cared for a middle-aged man with psoriasis vulgaris undergoing PUVA treatment who had tiny red papules develop along scratches on the trunk and extremities. The papular lesions were diagnosed histologically as neurofibromas. Until this time, he had not had any sign suggesting neurofibromatosis. Herein we describe this unusual case, and discuss the relationship between the development of neurofibromas and the cumulative exposure to PUVA. Report of a Case.— A 58-year-old Japanese man suffered from psoriasis vulgaris for the last 13 years. For the last 3 years, he has suffered from hyperthyroidism, which has been controlled with the daily