Is Darier’s disease difficult to treat?

Complete clearing of Darier’s disease is rare. Soothing moisturizers containing urea or lactic acid reduce scaling and irritation. Salicylic acid in a propylene glycol gel and topical retinoids are also effective in reducing crusts and scale, although retinoids may need to be initiated on an alternate-day schedule in combination with midpotency topical steroids to minimize irritation. Aggravating factors such as heat, humidity, sunlight, and lithium should be avoided. Infection should be prevented with antibacterial soaps and treated with antibiotics. Oral retinoids are effective, but toxicity limits their use; intermittent use may be preferable, such as starting the medication before a summer holiday to prevent suninduced exacerbations. Recalcitrant verrucous lesions have been treated with dermabrasion, carbon dioxide laser vaporization, and surgery.

Burge SM: Darier-White disease: a review of the clinical features in 163 patients, J Am Acad Dermatol 27:40–50, 1992.

Burge SM: Management of Darier’s disease, Clin Exp Dermatol 24:53–56, 1999.