Abstract
<h3>To the Editor.—</h3> I was interested in the report of Rau and his colleagues, in the MarchArchives, on photo-onycholysis occurring from sun exposure during psoralen treatment (114:448, 1978). They state that there are no reports of this in the medical literature. However, the association was described in two cases by Zala etal.<sup>1</sup>These patients were treated with methoxsalen and sun exposure for vitiligo. My colleague, Vella Briffa, and I reported a case of a patient undergoing psoralen -ultraviolet-A therapy for mycosis fungoides.<sup>2</sup>Rau and his colleagues list many other causes of photo-onycholysis, one they do not mention is porphyria. Recently, a woman with porphyria variegata came to me for treatment of photo-onycholysis of all her fingernails. Common to all the conditions in which photo-onycholysis has been described is the ability of long-wave ultraviolet light to penetrate the nail plate, whereas the shorter wavelength ultraviolet light does
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