Verruciform Manifestations of Keratosis Follicularis

A unique variant of Darier's disease

“…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.…”

“…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.…”

Congenital Wart-like Papules on Hands and Feet

“…Histopathology reveals the triad of “pure hyperkeratosis, acanthosis, and papillomatosis” described by Waisman (8). Classically, the papillomatosis may have a “church spire” appearance as a result of elevations of the epidermis noted by Schueller (3).…”

“…The differential diagnosis of AKV includes epidermodysplasia verruciformis, hyperkeratosis lenticularis perstans, seborrheic keratosis, stucco keratosis, and verruca plana (3,8). The linear distribution of the lesions observed in our patient is unique and important to emphasize given the potential clinical confusion with verruca plana.…”

Acrokeratosis Verruciformis of Hopf is Caused by Mutation in ATP2A2: Evidence That it is Allelic to Darier's Disease

“…of AKV being part of the DD spectrum is the presence of mixed pedigrees (Herndon and Wilson, 1966) and it is notable that 50% of Darier's patients have acral warty papules (Penrod et al, 1960;Waisman, 1960). There are reports of patients with AKV who later developed clinical features of DD ^one case concerned one of Hopf's original patients!…”