A 28-year-old female patient with pretibial myxoedema affecting both lower legs was treated with PUVA localized to the distal legs. The patient was given 8-methoxypsoralen in a dosage of 0.6 mg/kg 2 hours prior to UVA exposure (Waldmann PUVA 180 and 200 units). A total of 37 treatments, conducted over an 8-month period, gave a total exposure of 108.0 J/cm2and induced a clinical and histological remission. Loss of skin thickness was confirmed by a pulsed A-scan DM70 ultrasound of the affected sites. We discuss the use of PUVA as an effective treatment for a disfiguring condition which is otherwise resistant to therapy.xs