A patient with Darier disease has widespread malodorous hyperkeratotic papules despite trigger avoidance, emollients and appropriate topical therapy.

Question

A patient with Darier disease has widespread malodorous hyperkeratotic papules despite trigger avoidance, emollients and appropriate topical therapy. There is no pregnancy potential or retinoid contraindication. Which escalation is most rational?

Accepted Answer

Consider oral acitretin or isotretinoin with specialist retinoid monitoring after topical failure

Answer

Offer anti-IgE biologic therapy because ATP2A2 disease is driven by immediate allergy

Answer

Start high-dose prednisolone because Darier disease is an autoimmune blistering disorder

Answer

Use narrowband UVB because ultraviolet exposure usually suppresses Darier disease

Answer

Use indefinite oral flucloxacillin because odour proves continuous bacterial infection

Darier Disease — SCE Dermatology MCQ

A patient with Darier disease has widespread malodorous hyperkeratotic papules despite trigger avoidance, emollients and appropriate topical therapy. There is no pregnancy potential or retinoid contraindication. Which escalation is most rational?