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Generalized Pustular Psoriasis-Like Dermatophytosis due to Trichophyton rubrum

Acta Dermatovenerologica Croatica;
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  • Biology
  • Medicine


206 ACTA DERMATOVENEROLOGICA CROATICA Acta Dermatovenerol Croat 2011;19(3):206-211 LETTER TO THE EDITOR Effective Treatment of Linear Darier’s Disease with Topical Retinoids: Case Report and Review of the Literature Darier’s disease is a rare genodermatosis caused by a defect in ATP2A2 gene located on chromosome 12q23-23 (1). This somatic mutation rarely occurs in the postzygotic phase of embryogenesis, leading to cutaneous mosaicism for the disease. The mosaic form of Darier’s disease is also called linear Darier’s disease and clinically presents with linear, zosteri- form or localized patterns located on Blaschko’s lines. A case of linear Darier’s disease successfully treated with topical 0.1% tretinoin therapy is presented. A 62-year-old male patient presented to derma- tology department for scaly eruption on the back for over a month. The patient had undergone Whipple’s operation (pancreatoduodenosplenectomy) for pan- creatic adenocarcinoma 3 months before. Dermato- logic examination revealed unilateral follicular hy- perkeratotic papules in an oblique linear configura- tion over the patient’s back. Some keratotic papules coalesced to form plaques, which were located on Blaschko’s lines (Fig. 1). The remaining dermatologic examination of the hair, nails and mucosa was unremarkable. A punch biopsy performed from one of the papules showed focal suprabasilar acantholysis accompanied by dys- keratotic keratinocytes both in the stratum spinosum and stratum corneum. Dyskeratotic cells in the stra- tum spinosum showed pyknotic nuclei and enlarged homogeneous eosinophilic cytoplasm, whereas ba- sophilic elongated nuclei were observed in dyskera- totic cells of the stratum corneum (Fig. 2). They were consistent with corps ronds and grains previously de- scribed in dyskeratotic dermatoses and particularly in Darier’s disease (2). With these histopathologic find- ings, the diagnosis of Darier’s disease was made. The clinical presentation composed of localized plaques

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