Induction of Darier's Disease by Repeated Irradiation by Ultraviolet B; Protection by Sunscreen and Topical Ascorbic Acid

Abstract

Darier's disease, keratosis follicularis, is frequently aggravated by sun exposure. Although there have been reports of Darier's disease reproduced by repeated exposure to ultraviolet B, little is known about its photo-protection. We artificially induced Darier's disease in a 47-year-old Korean man, and tested the protection afforded by sunscreen and topical ascorbic acid. Complete lesions of Darier's disease arose with repeated exposure of ultraviolet B (2,600 mJ/cm2 for 10 days), and sunscreen and topical ascorbic acid protected against its appearance. This result strongly suggests that sunscreen and ascorbic acid would be very helpful in preventing the aggravation of Darier's disease caused by sun exposure.

Darier's (Darier–White) disease/keratosis follicularis

“…Hence, almost all patients have worse symptoms during the summer due to the heat and humidity. UVB light, 37,39,40 mechanical trauma, 25 oral lithium, 41,42 and phenol and ethyl chloride sprays 25 are other precipitating factors. Despite the absence of consistent immunologic abnormalities, the frequent occurrence of herpes simplex and various bacteriologic infections may exacerbate the condition 43–47 …”

A case of pityriasis rubra pilaris with associated focal acantholytic dyskeratosis complicated by Kaposi's varicelliform eruption

“…In addition, it is possible that phototherapy triggered a flare in this patient's FAD. For example, ultraviolet therapy is known to induce or exacerbate Darier's disease, 18,19 and heat and sweating have been associated with exacerbations of both Darier's and Grover's diseases 20,21 . Extensive acantholysis might then have promoted the superimposed herpes viral infection.…”

Molecular Pathogenesis and Complications Associated with Keratosis Follicularis: A Clinical Review

“…Additionally, the use of topical sunscreens and ascorbic acid have been shown to be effective in the prevention of disease flares. 9 DD has been reported in association with non-melanoma skin cancers (NMSC), including various basal cell carcinomas (BCC), as well as neuropsychiatric disorders such as Bipolar disorder. 10,11 Moreover, rare cases involving nail changes and ocular manifestations have also been observed in connection with DD.…”