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Marvin Rapaport, MD

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The Cutting Edge article "Successful Treatment of Severe Atopic Dermatitis in a Child and an Adult With the T-Cell Modulator Efalizumab"¹ in the May 2006 issue of the ARCHIVES discusses another medication for this disease with both short- and long-term potential for toxic effects added to the panoply of similar medications, including azathioprine, mycophenolate, cyclosporine, and other immunomodulators. As yet unknown adverse effects of efalizumab might preclude its long-term use. I suggest another approach to the "problem" of atopy before instituting treatments with new medications.

In the case report by Weinberg and Siegfried,¹ a diffuse erythema coupled with the typical eczematous patches in the popliteal area is seen in patient 1. I believe that this diffuse erythema represents corticosteroid addiction with rebound vasodilatation, not worsening eczema.^2-5 Patient 2 demonstrates "spongiotic dermatitis" on the skin biopsy specimen. All of the biopsy specimens from my patients who were . . . [Full Text of this Article]

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RELATED LETTERS

Serum Nitric Oxide Levels in "Red" Patients: Separating Corticosteroid-Addicted Patients From Those With Chronic Eczema
Marvin J. Rapaport and Vicki H. Rapaport
Arch Dermatol. 2004;140(8):1013-1014.
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Long-term Follow-up of a Child Treated With Efalizumab for Atopic Dermatitis
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RELATED ARTICLE

Successful Treatment of Severe Atopic Dermatitis in a Child and an Adult With the T-Cell Modulator Efalizumab
Jeffrey M. Weinberg and Elaine C. Siegfried
Arch Dermatol. 2006;142(5):555-558.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Long-term Follow-up of a Child Treated With Efalizumab for Atopic Dermatitis
Siegfried
Arch Dermatol 2007;143:1077-1078.
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