A case of Darier´s disease associated with acrokeratosis verruciformis in 22 years old male is reported.
The patient was suffered from the multiple grouped papulovesicular patches with burning sensation involving the scalp and the left upper abdomen 6´years ago, after severe sunburn in summer.
These skin lesions were spontaneously involuted in winter. But on next summer multiple small firm follicular papules were recurred on the left abdomen, and the lesions had a tendency to become worse in each summer season and spread out to the scalp, neck, shoulder, back, chest and abdomen.
The papules varying from pinhead to rice in its size and had a tendency to coalesce into patches and covered with dirty, greasy, brown or black crusts.
On the dorsal surfaces of the hands and feet, there were multiple verruca plana-like dirty warty excrescences from childhood.
Histopathology;
1) On the abdominal wall; (Darier´s disease)
The epidermis shows pronounced hyperkeratosis with focal downward prolongation and broadening of the rete ridges.
At one localized area in the epidermis, it shows dyskeratotic cells (corpus ronds), lacunae and villi formation. The skin appendages are scanty.
2) On the dorsum of the hand; (Acrokeratosis verruciformis)
The epidermis shows considerable hyperkeratosis, papillomatosis and thickening of the granular layer.
The rete ridges are broadened and moderately elongated and all extend to a uniform level. The sweat glands are well preserved.
Remarkable involution of the lesions were observed by oral administration of the
Vit. A 100 to 200 thousand unit/day and chloroquine 0.5gm./day for one month.
But the skin lesions have a tendency to recur after the ceasing of medication.
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