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There have been no reports of cutaneous malignancies arising in lesions of patients with Darier's disease. Two such cases are herewith reported, one a carcinoma of adnexal origin, and the other of several basal‐cell carcinomata. Possible predisposing factors are briefly discussed and speculated upon.

A 22-year-old white man from Brazil presented to our dermatology clinic for evaluation oflesions on the dorsal surface ofhis right hand and wrist. He had been in excellent health until endstage congestive heart failure secondary to viral myocarditis developed. Two months before his presentation, the patient had undergone cardiac transplantation for management of progressive heart failure. Before surgery, his skin was lesion free. Intravenous catheters were inserted perioperatively; 4 days postoperatively, necrosis developed on the dorsal aspect of his right wrist. Several weeks after transplantation, papules and plaques developed on the dorsal aspect of his right hand and wrist adjacent to the necrotic ulcerations (Fig 1).Because this patient was receiving immunosuppressive therapy to prevent transplant rejection, opportunistic infection was considered as a possible cause for these lesions. The cardiology clinic referred him to the dermatology service. At the time of presentation, these papules and plaques were yellow, indurated, nontender, and rough, with irregular margins, and varied from 2 mm to several centimeters. Adjacent to these plaques were two ulcérations covered with thick black eschars, the largest measuring 3.3 x 1.5 cm. A biopsy specimen was ob¬ tained, and tissue was submitted for histologie evaluation and culture (Figs 2 and 3). Appearance after 4 months is shown (Fig 4).

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