Chloroquine and chloroquine derivatives have proved successful in the therapy of REM syndrome (REMS). Alternative treatment schedules have not been described so far. In a female Patient, chloroquine therapy had to be discontinued because of ophthalmologic contraindication. PUVA therapy induced complete remission, whereas dapsone alone only led to incomplete improvement. Additional UV radiation--mainly UV-A--had a positive effect. Chloroquine contraindication justifies the use of these alternative therapeutic approaches to REMS.