Darier's disease is a flaw in the epidermal weave of the outer garment of the skin



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Darier's disease is a flaw in the epidermal weave of the outer garment of the skin.

@ Clinically, it is warty papules, palmoplanter pits and distinctive nail abnormalities.

@ Histologically: There are focal separation of suprabasal epidermal cells (acantholysis), suprabasal clifting/ or distinctive keratosis ( corps ronds and grains) which is a form of apoptosis.

Q: What are the predisposing factors for Darier's disease?


A: - Sunburn -Seborrheic dermatitis

-Acne -Intertrigo

-Folliculitis.
َQ:What are your main concern in a patient having Darier' s disease?
A: 1. Malodor is the first sign of secondary bacterial over-growth in moist papules.

2. Avoid superinfection with vaccina virus or herpes simplex. The patient has to be aware not to be vaccinated or not to come in contact with some one freshly vaccinated. Herpes simplex virus must be avoided. Kissing causes a special hazard for the patient. Nursing of the patient with a nurse having herpes simplex is another hazard.

Q: Why the papule of Darier's disease is rough in its surface?

A: Due to the presence of columns of parakeratotic cells over the lesional area.


Q: Is the parakertosis present in Darier's disease due to the presence of nuclei or actual cells in stratum corneum?

A: Ultrastructurly, it was found to be due presence of actual crumbled cells with remenant of their organells.


Q: What are the diseases which present with focal acantholytic dyskeratosis?

A: 1. Darier's disease

2. Warty dyskeratoma.

3. Grover's disease (Transient acantholytic dyskeratosis)



4. Epidermal nevi.

5. Above dermatofibroma


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