ISSN: 2574-7800
Authors: Thakur S, Pise G, Prasad SP and Manohar N*
Darier disease is a rare autosomal dominant skin disorder resulting from mutation of the ATP2A2 gene on chromosome 12. Its progressive course makes its precise diagnosis crucial for a good prognosis. A 60-year-old female presented with multiple non-itchy papules over the face, trunk, and extremities since childhood and photosensitivity with similar lesions in the mother and two elder sisters. Examination revealed skin-coloured-to-hyperpigmented, firm and greasy papules with cobblestone appearance. Dirty yellowish-white wart-like lesions were noted over the toes. Histopathology revealed parakeratosis, papillomatosis, suprabasal acantholysis, and cleft with corps rounds in the granular layer. Dermoscopy revealed cobblestone appearance of the toes with tire-tread and cracked river-bed-like appearance and nails showing palmar hemorrhages and V-shaped nicking. The patient was diagnosed with Darier disease and treated accordingly. Uniquely, the cobblestone appearance was noted first over the dorsa of hands and feet. Dermoscopy may be used diagnose the disease while awaiting histopathological evidence.
Keywords: Darier Disease; Dermoscopy
