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To the Editor: Dr Schiffmann and colleagues¹ reported that intravenous administration of -galactosidase A has a number of beneficial effects in patients with Fabry disease. However, it would be of interest to know the extent of the patients' cutaneous lesions^2-3 and whether they were affected by treatment with -galactosidase A.

If a change in the cutaneous lesions is noticed, this might correspond to the observed improvements in neuropathic pain, mesangial widening, inulin and creatinine clearance, plasma glycosphingolipid level, cardiac conduction, and body weight. If so, a simple cutaneous marker for the effect of the therapy could be established. Furthermore, in cases of lesional improvement, invasive procedures (eg, laser therapy) for the telangiectatic spots could be reduced or even avoided.

Matthias Möhrenschlager, MD; Johannes Ring, MD,PhD; Dietrich Abeck, MD
Department of Dermatology and Allergy Biederstein
Technical University of Munich
Munich, Germany

1. Schiffmann R, Kopp JB, Austin III HA, et al. Enzyme replacement therapy in Fabry disease: a randomized controlled trial. JAMA. 2001;285:2743-2749. FREE FULL TEXT 2. Hurwitz S. Angiokeratomas. In: Hurwitz S, ed. Clinical Pediatric Dermatology. 2nd ed. Philadelphia, Pa: WB Saunders; 1993:259-263. 3. Black MM. Angiokeratoma corporis diffusum. In: Champion RH, Burton JL, Ebling FJG, eds. Textbook of Dermatology. 5th ed. Oxford, England: Blackwell; 1992:2344-2346.

In Reply: In the 6-month trial we reported, the extent . . . [Full Text of this Article]

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