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Savinova I, Tarafdar N, Sachdeva M, Abduelmula A, Maliyar K, Georgakopoulos JR, Mufti A, Yeung J. Hospitalization and Mortality in Patients With Darier Disease Complicated by Kaposi Varicelliform Eruption: A Systematic Review. J Cutan Med Surg 2024:12034754241239273. [PMID: 38468195 DOI: 10.1177/12034754241239273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- Iryna Savinova
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nawar Tarafdar
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Muskaan Sachdeva
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Abrahim Abduelmula
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Khalad Maliyar
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Jorge R Georgakopoulos
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Asfandyar Mufti
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jensen Yeung
- Department of Medicine, Division of Dermatology, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
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Sajid S, Adwani R, Safdar MA, Talal U, Fazal MI. Exacerbation of Very Late-Onset Darier Disease With COVID-19 Infection: A Case Report. Cureus 2023; 15:e43353. [PMID: 37700977 PMCID: PMC10493457 DOI: 10.7759/cureus.43353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Darier disease is an uncommon hereditary skin disorder characterized by the presence of hyperkeratotic papules and plaques affecting seborrheic areas. The uniqueness of this case lies in the exceptionally late-onset pattern of Darier disease, involving an 82-year-old female patient, and its correlation with COVID-19 infection. The patient had a history of a scaly and itchy rash limited to her arms, initially misdiagnosed as dermatitis, which persisted and worsened over three months. The manifestation of classical features of Darier disease coincided with her recent contraction of COVID-19. This instance emphasizes the varying manifestations of Darier disease that appear very late in life, which could result from new mutations or partial penetrance. Additionally, this case points out the potential worsening of Darier disease when combined with a COVID-19 infection. It highlights the need to be aware of atypical clinical progressions and the potential for increased severity of skin disorders during COVID-19. More studies are essential to grasp the relationship between COVID-19 and inherited skin conditions, aiming to improve patient treatment and care approaches.
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Affiliation(s)
- Samar Sajid
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Rahul Adwani
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | - Umer Talal
- Medicine, Services Hospital Lahore, Lahore, PAK
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Chyl-Surdacka K, Borzęcki A, Latifa J, Turska-Kozłowska M, Majchrzycka M. Keratosis follicularis (Darier disease) - clinical characteristics and treatment - a review and update. Postepy Dermatol Alergol 2023; 40:337-340. [PMID: 37545821 PMCID: PMC10399679 DOI: 10.5114/ada.2022.124344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 08/08/2023] Open
Abstract
Darier disease is one of the most common genodermatoses. Although Darier disease was described in 1886, targeted therapies remain unknown. Current literature lacks specific guidelines for treatment of Darier disease. Treatment remains symptomatic and may be challenging for dermatologists. The aim of this article is to present clinical characteristics and treatment options. In a mild form of the disease with a small number of skin lesions, the symptoms can be reduced by the use of topical medications. Oral retinoids, alternatively doxycycline, seem to be beneficial in extensive and persistent lesions unresponsive to local treatment. In limited, hypertrophic forms, surgical methods, laser therapy and photodynamic therapy could be used.
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Affiliation(s)
| | - Adam Borzęcki
- Department of Dermatology, Non-Public Health Care Center ‘Med-Laser’, Lublin, Poland
| | - Jakub Latifa
- Department of Dermatology, Non-Public Health Care Center ‘Med-Laser’, Lublin, Poland
| | - Monika Turska-Kozłowska
- Department of Dermatology, Non-Public Health Care Center ‘Med-Laser’, Lublin, Poland
- Department of Molecular Biology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Marianna Majchrzycka
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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Miyazaki A, Taki T, Takeichi T, Kono M, Yagi H, Akiyama M. Darier disease successfully treated with a topical agent containing vitamin A (retinyl palmitate), vitamin E, and urea. J Dermatol 2022; 49:779-782. [PMID: 35437850 DOI: 10.1111/1346-8138.16395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/13/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Darier disease (DD), also called keratosis follicularis, is an autosomal dominant hereditary keratinization disorder that manifests as keratotic papules with plaques in seborrheic areas. There are no validated curative treatments for DD, with the majority of cases treated symptomatically. We report the efficacy of a topical over-the-counter agent which contains retinyl palmitate, vitamin E, and urea for a patient with DD. A 13-year-old girl had brown papules on her scalp, neck, shoulders, and axillae since entering elementary school. A skin biopsy revealed hyperkeratosis, suprabasal acantholysis, and dyskeratosis manifested as corps ronds and grains in the epidermis. Sanger sequencing found the previously reported heterozygous mutation c.1484C>T in ATP2A2. The application of an over-the-counter topical agent containing retinyl palmitate 2750 μg/g (5000 IU/g), tocopheryl acetate 20 mg/g, urea 200 mg/g, and monoammonium glycyrrhizinate 5 mg/g twice daily for 2 months improved the papules without serious adverse events. Oral or topical aromatic vitamin A analogs (retinoids) are often used to treat DD. However, several adverse events are associated with retinoid treatment, and many patients only undergo their intermittent use or discontinue the treatments. Retinyl palmitate is more stable and has a lower irritative profile than other retinoic acids. When applied topically, however, retinyl palmitate cannot penetrate the skin as well as retinol can. Some reports have noted that vitamin E increases the biological availability of vitamin A and that urea helps mechanical percutaneous drug delivery. Our case suggests that retinyl palmitate has a sufficient therapeutic effect when combined with vitamin E and urea. In conclusion, we propose that topical agents containing retinyl palmitate, vitamin E, and urea might have a satisfactory effect on the skin lesions of DD patients, without the serious risks of adverse events.
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Affiliation(s)
- Akira Miyazaki
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoki Taki
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihiro Kono
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroaki Yagi
- Department of Dermatology, Shizuoka General Hospital, Shizuoka, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Abstract
Darier's disease is an uncommon chronic dermatosis of autosomal dominant inheritance with significant psychosocial morbidity and shows unsatisfactory response to several topical and systemic therapies or various resurfacing or surgical procedure. A 24-year-old woman having characteristic asymptomatic and progressive, hyperkeratotic papular lesions involving the scalp, face, upper trunk, and dorsal hands and feet was diagnosed clinicopathologically as Darier's disease. She was treated successfully with oral Vitamin A 25000 IU given twice daily. The response was apparent within 4 weeks and most lesions cleared in 2 months without any adverse effects. Oral Vitamin A provides an effective and safe low-cost therapeutic alternative in Darier's disease, especially when systemic retinoids, the only effective treatment, remain contraindicated or is not tolerated and for maintenance therapy in the long-term.
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Affiliation(s)
- Megha Sondhi
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Sanket Vashist
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Affiliation(s)
- Jennifer Nicole Harb
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
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Abstract
Darier disease (DD), also known as keratosis follicularis or dyskeratosis follicularis, is a rare autosomal dominant genodermatosis with high penetrance and variable expressivity. It is caused by mutations of ATP2A2 gene which encodes the sarco/endoplasmic reticulum Ca2+ ATPase isoform 2. It is clinically manifested by hyperkeratotic papules primarily affecting seborrheic areas on the head, neck and thorax, with less frequent involvement of the oral mucosa. When oral manifestations are present, they primarily affect the palatal and alveolar mucosa, are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions show suprabasal clefts with acantholytic and dyskeratotic cells. We present a case of 35-year-old female patient with typical clinical and histological features of DD.
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Affiliation(s)
- Hema Suryawanshi
- Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Akshay Dhobley
- Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Aparna Sharma
- Department of Oral Pathology and Microbiology, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
| | - Pramod Kumar
- Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
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Klimas N, West C, Tarbox M. A Bullous Flare of a Hyperkeratotic Affair: A Case Report. J Cutan Med Surg 2016; 20:589-591. [PMID: 27407050 DOI: 10.1177/1203475416660295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Darier's disease is an autosomal dominant genodermatosis typified by hyperkeratotic papules and plaques in a predominately seborrheic distribution. The vesiculo-bullous variant of Darier's disease is rare. Several previously reported cases have demonstrated clinical and microscopic features resembling familial benign chronic pemphigus or Hailey-Hailey disease. OBJECTIVES The objective of this report is to describe an uncommon presentation of Darier's disease, which has been infrequently described in the literature. METHODS The authors present a case of bullous flare of long-standing Darier's disease. CONCLUSIONS Darier's disease may assume several atypical morphologies, including vesiculo-bullous lesions.
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Affiliation(s)
- Natasha Klimas
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Cameron West
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Michelle Tarbox
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Abstract
Genodermatoses are an inherited disorder, present with multisystem involvement. Help us to identify regular mutations and appalling skin diseases with recessive inheritance. Genetic heterogeneity is very common, and molecular diagnosis requires a broad effort. Recurrent mutations in unrelated families were seen in families with xeroderma, Griscelli. It seems likely that eventually oligonucleotide arrays will replace most other methods for routine mutation scanning of the more common diseases and planned sequencing will be increasingly used for rarer diseases.
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Affiliation(s)
- N Aravindha Babu
- Department of Oral pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - E Rajesh
- Department of Oral pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Jayasri Krupaa
- Department of Oral pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - G Gnananandar
- Department of Oral pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
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Abstract
Darier's disease (DD) is a dominantly inherited genodermatosis with highly variable expression. It is characterized by symmetrical hyperkeratotic papules affecting seborrheic areas and extremities. The existence of unsightly lesions could lead to discomfort and social handicap. Conventional treatment consists of topical and systemic steroids and/or retinoids alleviating DD. Ablative lasers also have been used to treat these conditions with variable results and side effects. To the best of our knowledge, fractional CO2 laser has never been used to treat DD. We present a case of a 36-year-old woman with verrucous and hyperkeratotic plaques of the forehead significantly improved after two sessions of fractional CO2 laser treatment. Neither scars nor pigmentary disorders were noted.
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Affiliation(s)
- Rym Benmously
- Dermatology Department, Habib Thameur Hospital, Laboratoire de recherche , Tunis , Tunisia
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Abstract
Darier-White disease (keratosis follicularis) is a rare disorder of keratinization involving the epidermis, mucous membranes, and nails. It is said to occur as a result of mutation in the ATP2A2 gene located on chromosome 12q23-24.1. In this article we present the case of two brothers with exacerbations of Darier-White disease who responded very well to systemic retinoids without any side effects within 2 weeks of commencing treatment.
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Affiliation(s)
- Ramesh M Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Kankanady, Mangalore - 575 002, India
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