Verruciform Manifestations of Keratosis Follicularis

Waisman, Morris

doi:10.1001/archderm.1960.03730010005001

Cited by 29 publications

(16 citation statements)

References 11 publications

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“…Our patient's hands, however, had numerous, hypopigmented, flat‐topped papules. These papules differ in color from the typical lesions of acrokeratosis verruciformis‐like papules seen in Darier's disease, which are described as flesh‐colored to hyperpigmented, flat‐topped or verrucous papules 8 . A biopsy of a representative, hypopigmented papule confirmed our diagnosis of keratosis follicularis.…”

Section: Discussionsupporting

confidence: 60%

“…These papules differ in color from the typical lesions of acrokeratosis verruciformis-like papules seen in Darier's disease, which are described as¯esh-colored to hyperpigmented,¯at-topped or verrucous papules. 8 A biopsy of a representative, hypopigmented papule con®rmed our diagnosis of keratosis follicularis. We present this case to make dermatologists aware of this unusual clinical variant of Darier's disease, which is unique to dark-skinned patients and includes hypopigmented macules and papules alone or in combination with more classic keratotic papules.…”

Section: Discussionmentioning

confidence: 61%

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A unique variant of Darier's disease

Peterson¹,

Lesher²,

Sangüeza³

2001

Int J Dermatology

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A 45-year-old black woman presented with a chief complaint of an increasing number of "light spots" on her face, upper trunk, and legs. She had a 4-year history of a pruritic eruption on the dorsum of her hands. The eruption was particularly pruritic in the summer months. Other family members, including her sister and her daughters, reportedly had a similar dermatologic problem. The patient had been previously evaluated and biopsied by another dermatologist. The earlier biopsy was nondiagnostic, however, and she presented for further evaluation of this problem. On physical examination, the patient had hypopigmented macules along her jawline (Fig. 1), lateral neck, and upper chest. She had similar hypopigmented macules on her thighs. She had hyperkeratosis of the palmoplantar surface of her hands and feet. The dorsum of her hands had numerous coalescing, shiny, flat-topped, hypopigmented papules (Fig. 2), and several of her fingernails had distal, V-shaped notching. A punch biopsy from a papule on the dorsum of her hand was obtained. The epidermis had corps ronds present with focal areas of acantholysis above the basal layer (Fig. 3). The dermis had sparse, superficial, perivascular infiltrates composed of lymphocytes and histiocytes. These changes were consistent with our clinical diagnosis of Darier's disease (keratosis follicularis).

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 61%

A unique variant of Darier's disease

Peterson¹,

Lesher²,

Sangüeza³

2001

Int J Dermatology

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“…The differential diagnosis of AKV includes verruca plana, Darier disease, epidermodysplasia verruciformis, lichen planus and stucco keratoses. Clues to the diagnosis of AKV may include a family history of similar lesions, the clinical extent and distribution of lesions and the distinctive pathological findings of ‘pure hyperkeratosis, acanthosis and papillomatosis’ 3 without acantholysis, dyskeratosis, parakeratosis or viral cytopathic change. There is no standard treatment for AKV.…”

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confidence: 99%

A sporadic patient with acrokeratosis verruciformis of Hopf and a novel ATP2A2 mutation

Berk

Taube²,

Bruckner³

et al. 2010

British Journal of Dermatology

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References 1 Resnik KS, Kantor GR, Lessin SR et al. Mycosis fungoides palmaris et plantaris. Arch Dermatol 1995; 131:1052-6. 2 Gathers RC, Scherschun L, Malick F et al. Narrowband UVB phototherapy for early-stage mycosis fungoides. J Am Acad Dermatol 2002; 47:191-7. 3 Kontos AP, Kerr HA, Malick F et al. 308-nm excimer laser for the treatment of lymphomatoid papulosis and stage IA mycosis fungoides. Photodermatol Photoimmunol Photomed 2006; 22:168-71. 4 Meisenheimer JL. Treatment of mycosis fungoides using a 308-nm excimer laser: two case studies. Dermatol Online J 2006; 12:11. 5 Mori M, Campolmi P, Mavilia L et al. Monochromatic excimer light (308 nm) in patch-stage IA mycosis fungoides. J Am Acad Dermatol 2004; 50:943-5. 6 Nistico S, Costanzo A, Saraceno R et al. Efficacy of monochromatic excimer laser radiation (308 nm) in the treatment of early stage mycosis fungoides. Br J Dermatol 2004; 151:877-9. 7 Passeron T, Zakaria W, Ostovari N et al. Efficacy of the 308-nm excimer laser in the treatment of mycosis fungoides. Arch Dermatol 2004; 140:1291-3. 8 Novak Z, Bonis B, Baltas E et al. Xenon chloride ultraviolet B laser is more effective in treating psoriasis and in inducing T cell apoptosis than narrow-band ultraviolet B. J Photochem Photobiol B 2002; 67:32-8. MADAM, Acrokeratosis verruciformis (AKV) is a rare autosomal dominant or sporadic genodermatosis. Affected individuals demonstrate asymptomatic, flat-topped, skin-coloured papules on the dorsal hands and feet. On histological examination, AKV demonstrates marked compact orthokeratosis, hypergranulosis, mild regular acanthosis and variable 'church spire' papillomatosis, without viral cytopathic changes, parakeratosis, acantholysis or dyskeratosis. It has long been hypothesized that AKV is allelic to Darier disease. However, the literature contains just two reports of genetic analyses of patients with AKV, 1,2 only one of which documented mutations in ATP2A2, which is the gene defect in Darier disease. 1 That report included one family with a novel P602L mutation in ATP2A2.Here, we present the second report of ATP2A2 mutations in AKV, in this case resulting in an A698V codon change which has never been described in patients with either AKV or Darier disease. An 11-year-old Afghani boy presented with a 6-year history of asymptomatic bumps on the hands and feet. He had been diagnosed with verruca plana and treated with cryotherapy, cimetidine and topical tretinoin, imiquimod and salicylic acid, none of which resulted in significant improvement. Past medical history was unremarkable. There was no family history of similar lesions, Darier disease or consanguinity. Physical examination revealed 1-4-mm verrucous, flat-topped papules over the dorsal hands, wrists, feet and ankles (Fig. 1). The remaining physical examination was normal, including palms and nails. A shave biopsy from the hand taken 4 years earlier at an another institution, and a repeat shave biopsy (Fig. 2) from the hand both demonstrated marked hyperkeratosis overlying a slightly acanthotic epiderm...

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“…In der Literatur wurde wiederholt über das Vorkommen von warzenartigen Hautveränderungen an den Hand-und Fuß-rücken bei Patienten mit Morbus Darier berichtet [9,19,21]. Es wird kontrovers diskutiert, ob es sich hier um eine Acrokeratosis verruciformis bei einem M. Darier [8,9,15] oder um klinisch ungewöhnliche Veränderungen des M. Darier handelt [12][13][14]20].…”

Section: Gustav Hopf Berichtete 1931 üBerunclassified

“…Bei anderen Patienten traten anfangs nur die beschriebenen warzenartigen Veränderungen auf, und sie entwickelten erst später typische Hauterscheinungen im Sinne eines M. Darier. Sowohl Hopf [8,9] als auch andere Autoren [15,17] [20] und Yamamoto [21] bestätigen und fanden histologisch, allerdings meist erst in Stufenschnitten, suprabasale Spaltbildungen mit Akantholyse und Dyskeratose, wie sie für M. Darier typisch sind.…”

Section: Besprechungunclassified

Acrokeratosis-verruciformis-ähnliche Veränderungen beim Morbus Darier

Hafner

Vakilzadeh

1997

Der Hautarzt

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In the literature, a number of observers reported that acrokeratosis verruciformis (Hopf) often evolves in cases of keratosis follicularis. The relationship of these verruciform manifestations to keratosis follicularis is discussed. In this paper, we present three patients with Darier's disease, who have verruciform papules on the dorsal surfaces of the hands and feet. Histopathologically, the papules showed the distinctive structures of Darier's disease. Therefore, these lesions are regarded as an abortive form of keratosis follicularis. It is necessary to examine carefully the punch biopsies histomorphologically. We also recommend having a closer look at the development of other typical Darier's skin lesions in the follow-up of patients.

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Verruciform Manifestations of Keratosis Follicularis

Cited by 29 publications

References 11 publications

A unique variant of Darier's disease

A unique variant of Darier's disease

A sporadic patient with acrokeratosis verruciformis of Hopf and a novel ATP2A2 mutation

Acrokeratosis-verruciformis-ähnliche Veränderungen beim Morbus Darier

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