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Caoimhe D, Wood B, Foster R, Ricciardo B. Mosaic Darier disease flaring following allogeneic stem cell transplant. Australas J Dermatol 2024; 65:221-223. [PMID: 38225856 DOI: 10.1111/ajd.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Dalton Caoimhe
- Fiona Stanley Hospital, Perth, Western Australia, Australia
| | | | - Rachael Foster
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Dhanaraj M, Danny GC, Srinivasan S, Nagaraju S. Late onset Darier's disease in a genetically predisposed individual: a case report. Pan Afr Med J 2022; 42:208. [PMID: 36284569 PMCID: PMC9547030 DOI: 10.11604/pamj.2022.42.208.32696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Keratosis follicularis also called as Darier's disease, is a rare autosomal dominant cutaneous disease. It is characterized by greasy keratotic sometimes crusted red to brown papules and plaques over seborrheic areas and in flexures with nail abnormalities. It is well established that the disease begins between the ages of 6 and 20 years, with a peak onset during puberty. The disease tends to manifest early, especially with the family history of the disease. Hereby, we report a case of Darier's disease with a special interest in its late onset presentation despite having significant family history of the disease, along with clinicopathological and dermoscopic features. We also highlight the use of non-invasive investigative technique of dermoscopy as a tool to diagnose the disease.
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Affiliation(s)
- Manoharan Dhanaraj
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600044, India
| | - Geo Celestin Danny
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600044, India
| | - Shreya Srinivasan
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600044, India,Corresponding author: Shreya Srinivasan, Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600044, India.
| | - Sowmya Nagaraju
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600044, India
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Darier Disease with Psoriasis. Medicina (B Aires) 2022; 58:medicina58070902. [PMID: 35888621 PMCID: PMC9319658 DOI: 10.3390/medicina58070902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Darier disease is an autosomal dominant disorder with dark crusty patches and is classified as hereditary acantholytic dermatosis. Keratotic papules and crust are often present on the scalp, forehead, chest, back, upper arms, elbows, groin, and behind the ears, predominantly in seborrheic areas. A 48-year-old male patient presented skin lesions with pruritus on the trunk and both upper and lower extremities. He first noticed the lesion 15 years before. On physical examination, there were multiple erythematous papules with crust on the trunk and red-brown colored keratotic plaque on both extremities. The suspected histopathological diagnosis was psoriasis vulgaris. The patient’s skin lesions and pruritus were significantly improved after the psoriasis treatment. While continuing psoriasis treatment, the patient showed sudden worsening of the skin lesions on the scalp, abdomen, and fingernails (V-shaped nicks) with pruritus. Punch biopsy was performed on the abdominal lesion again and the final diagnosis was Darier disease. The patient was then treated using alitretinoin while maintaining the use of guselkumab for psoriasis. There are only a few cases that we found in which patients with Darier disease also had psoriasis. We report this rare case of Darier disease with psoriasis and propose that an additional biopsy might be necessary for accurate diagnosis and proper treatment.
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Oral Mucosa and Nails in Genodermatoses: A Diagnostic Challenge. J Clin Med 2021; 10:jcm10225404. [PMID: 34830686 PMCID: PMC8618664 DOI: 10.3390/jcm10225404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Genodermatoses represent a group of uncommon, hereditary, single-gene skin disorders, characterized by multisystem involvement, heterogeneous clinical manifestations and different degrees of morbidity and mortality. Some genodermatoses may have oral mucosa and nail involvement, since the oral cavity and cutaneous organ system, including nails, share a close embryologic origin. Nail disorders can manifest with nail hypoplasia or nail hypertrophy. Clinical pictures of affected oral mucosa can be extremely heterogeneous, ranging from asymptomatic papules to painful blisters, leukokeratosis, oral papillomas and fibromas to oral potentially malignant disorders and cancerous lesions. Oral mucosa and nails pathological features may occur synchronously or not and are usually associated with other systemic and skin manifestations. In some cases, oral mucosa and nails diseases may be distinct and constitute the principal sign of the genetic disorder, in other cases they represent only a part of the puzzle for the confirmation of the diagnosis. Continued awareness of the correlation between oral mucosa and nails findings can help physicians to diagnose genodermatosis in a timely manner, allowing more effective clinical management and prevention and/or early detection of complications. This article provides an overview of all specific genodermatoses affecting both oral mucosa and nails. Moreover, the correlation between teeth and nails is summarized in tabular form.
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Rogner DF, Lammer J, Zink A, Hamm H. Morbus Darier und Morbus Hailey‐Hailey: Stand 2021. J Dtsch Dermatol Ges 2021; 19:1478-1502. [PMID: 34661362 DOI: 10.1111/ddg.14619_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/28/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Danielle Franziska Rogner
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Judith Lammer
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Alexander Zink
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
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Rogner DF, Lammer J, Zink A, Hamm H. Darier and Hailey-Hailey disease: update 2021. J Dtsch Dermatol Ges 2021; 19:1478-1501. [PMID: 34661345 DOI: 10.1111/ddg.14619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/28/2021] [Indexed: 01/16/2023]
Abstract
The autosomal-dominant genodermatoses Darier disease and Hailey-Hailey disease present special challenges to dermatologists. Despite their similar pathogenesis featuring impaired adhesion of suprabasal keratinocytes as a result of defective ATPases in epidermal calcium channels, the two diseases differ considerably in clinical presentation and therapeutic options. Darier disease is characterized by reddish brown, keratotic papules in seborrheic and intertriginous areas, which may coalesce into extensive lesions. Individuals affected with Hailey-Hailey disease primarily develop intertriginous papulovesicles and small blisters, which often evolve into erythematous plaques with erosions and painful fissures. Quality of life is significantly reduced because of complaints (itch, burning sensation, pain), body malodor and chronicity. Therapeutic options remain limited. Antiseptics and intermittent topical corticosteroids are a cornerstone of therapy, and systemic anti-infective treatment is often required in cases of superinfection. Ablative surgical interventions such as dermabrasion and CO2 laser surgery can lead to long-term remissions in intertriginous Hailey-Hailey disease, while temporary relief may also be achieved by intralesional injections of botulinum toxin. Of the systemic medications available for Darier disease, acitretin, which is approved for this purpose, has the best supporting evidence. The efficacy of immunosuppressants and immune modulators is inconsistent. Low-dose naltrexone produces more satisfactory results in Hailey-Hailey than Darier disease. The present CME article summarizes current knowledge of the two dermatoses, taking recent developments into account.
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Affiliation(s)
- Danielle Franziska Rogner
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Judith Lammer
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Henning Hamm
- Department of Dermatology, Venereology and Allergology, University Würzburg, Würzburg, Germany
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Patel TS, Herrera-Martinez M. Darier Disease. Mayo Clin Proc 2021; 96:688-689. [PMID: 33673919 DOI: 10.1016/j.mayocp.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Tejesh S Patel
- Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis
| | - Miguel Herrera-Martinez
- Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis
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Kositkuljorn C, Suchonwanit P. Darier's Disease: Report of a Case with Facial Involvement. Case Rep Dermatol 2020; 11:327-333. [PMID: 31911771 DOI: 10.1159/000504925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/20/2019] [Indexed: 11/19/2022] Open
Abstract
Darier's disease is a relatively rare autosomal dominant genodermatosis with a defect in the desmosomal attachment due to a mutation in the ATP2A2 gene. The condition is characterized by multiple hyperkeratotic papules predominantly in seborrheic areas on the head, neck, and trunk, with less frequent involvement of the oral mucosa. Histopathologically, the lesions reveal suprabasal clefts in the epithelium with acantholytic and dyskeratotic cells. Facial involvement in Darier's disease is one of the common presenting features. However, it has been once reported in a severe, chronic form as leonine facies in a long-standing case. To raise awareness of facial involvement in Darier's disease, we herein report a 65-year-old female patient with prominent facial lesions.
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Affiliation(s)
- Chaninan Kositkuljorn
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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