What is the role of surgery in the treatment of keratosis follicularis (Darier disease)?

Updated: Jul 31, 2018
  • Author: Pui-Yan Kwok, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Dermabrasion has been used to smooth the hyperkeratotic lesions of keratosis follicularis (Darier disease), with acceptable results. [60]

Electrosurgery [61] and Mohs micrographic surgery have been used to treat localized keratosis follicularis (Darier disease) areas, with good results.

Laser ablation of recalcitrant plaques has been reported. In one report, 3 patients were treated with carbon dioxide lasers, [62, 63, 64] 2 with Er:YAG lasers, [65] and 2 with pulsed-dye lasers. [66] In all of these cases, treatment was successful, with only one patient developing disease recurrence in her axilla 7 months after treatment. Other reports describe resolution of disease using 1550-nm erbium-doped fractional fiber laser and other fractionated resurfacing devices. [67, 68]

Carbon dioxide laser ablation with adjunctive dermabrasion, curettage, and shave excision in various combinations have also been reported to cause disease remission for 8 months to 2 years. [69]

Electron beam therapy has been used successfully for localized, recalcitrant Darier’s disease in a 51-year-old female. [70]

Photodynamic therapy with 5-aminolevulinic acid was used to treat keratosis follicularis (Darier disease) lesions in 6 patients, with 4 patients showing sustained improvement or clearance for a follow-up period of 6 months to 3 years. [71, 72]

Surgical excision of hypertrophic intertriginous keratosis follicularis has been described in one case report. [73]


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