This protocol addresses patients with Darier disease whose skin involvement is localized — not disseminated or generalized — and who have not achieved adequate relief with first-line supportive and symptomatic management.
Initial management of localized Darier disease typically includes supportive and symptomatic care: emollients, soap substitutes, cotton clothing, photoprotection, and careful avoidance of exacerbating factors. When this approach fails to achieve improvement of pruritus and skin irritation, a more targeted treatment step is indicated.
Complete resolution of symptoms and marked improvement of skin lesions.
DOI: 10.25259/IJDVL_963_19
For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices.
In 16 patients with a mean age of 43 (half of which were males), a formulation of 0.05% applied twice daily for 3 months was used.
Formulations of 0.1% isotretinoin were used by 3 patients for 1 to 3 months, with complete resolution of symptoms in 1 patient.
A total of 4 women with a mean age of 45 years used Tazarotene 0.05% and 0.1% daily with complete resolution of their symptoms.
Adapalene gel, a synthetic retinoid, was used in a total of 3 patients at a concentration of 0.1% daily for 2 months; all showed marked improvement with no side effects.
They have mostly been used in association with retinoids to reduce irritation.
Of those, 6 (35%) patients showed complete resolution of symptoms with only 1 patient experiencing a relapse following a month of treatment discontinuation.
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