To the editor: Recent uncontrolled trials of dialytic therapy of psoriasis suggest a remarkable clinical improvement (1–3). However, this disease may manifest spontaneous improvements and exacerbations (4); thus, assessment of the effects of dialysis is difficult to interpret. In this regard, Friedman and Delano have described in the January 1979 issue (5) a case of psoriasis developing de novo during hemodialysis. We report the clinical course of two patients who began dialysis several years after the onset of psoriasis.
A 43-year-old man with diabetic nephropathy developed typical cutaneous lesions of psoriasis in 1976. The diagnosis was confirmed by skin biopsy.