Darier’s disease: a summer scourge

IF THIS was an elderly person, you would diagnose Grover’s disease, where the keratotic papules are associated with sweat retention and sweat gland rupture causing the rash.

In someone of this age, Grover’s is unlikely, but the typical histological feature of acantholysis or separation of the keratinocytes is the same. Her diagnosis though is Darier’s disease, an autosomal dominant disorder with keratotic papules in the greasy areas of the skin and worse in areas where you might sweat excessively such as under the breasts and in the groin. It