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Darier's disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Darier's disease, also known as Darier-White disease or keratosis follicularis, is a genetic disorder of keratinisation based mainly on hair follicles that is inherited as an autosomal dominant trait (1).

The underlying defect resides with a disorder of cytoskeletal tonofibrils and desmosomes. A keratin-coding gene on the long arm of chromosome 12 has been implicated.

It usually presents in the first or second decade of life (before the third to fourth decades of life) (2). Both sexes are equally affected.

Diagnosis is made on showing dyskeratotic epidermal cells and epidermal clefts after skin biopsy.

Darier's disease is aggravated by sunlight, sweating, mechanical trauma and infection (2)

The underlying defect resides with a disorder of cytoskeletal tonofibrils and desmosomes. A mutation in the long arm of chromosome 12 (ATP 2A2 gene) which encodes SERCA2 (sarco/endoplasmic reticulum calcium)-ATPase pump has been implicated (1).

Diagnosis is made on showing dyskeratotic epidermal cells and epidermal clefts after skin biopsy.

Remissions and relapses can be seen usually during the course of the disease (2).

Except for a few patients who develop psychiatric symptoms (due to neighbouring gene co-segregation) all the other affected individuals develop only epidermal symptoms (2).

References:

  1. Khachemoune A, Lockshin B.N. Chronic papules on the back and extremities. JFP 2004;53(5).
  2. Szigeti R, Kellermayer R. Autosomal-Dominant Calcium ATPase Disorders. JID 2006;126:2370-2376.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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