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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the article by Sadeh et al¹ in the June 1997 issue of the ARCHIVES. Their observations are extremely interesting, and deepen the knowledge of the subject of systemic effects of skin diseases. We would like to add another patient to their list of 6 published case reports to support their opinion of a higher than reported incidence of acute respiratory distress syndrome as a complication of severe forms of psoriasis.

Two years ago, we described² a 48-year-old woman with generalized pustular psoriasis who developed acute respiratory distress syndrome. She had no evidence of infection or heart failure (documented by Doppler echocardiography) and she was being treated with etretinate. She received intensive care but her illness resulted in death. Postmortem findings were diagnostic of acute respiratory distress syndrome.

We, as did McGregor et al,³ considered interleukin 1, tumor necrosis factor , and interleukin 2 as cytokines probably . . . [Full Text of this Article]

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