The co-existence of Darier disease (DD) and acrokeratosis verruciformis of Hopf (AKV) has been noted for decades and the relationship between the 2 entities remains controversial. Although, it has been shown that both diseases are associated with mutations in ATPA2 gene, it is yet to be determined if they are the same disease, or separate but allelic, or interlinked in some other fashion. Herein, the authors report the case of a 13-year-old girl presenting with shiny flat-topped verruca plana–like papules, on the dorsal hands and feet and red–brown crusted papules on her forehead and along the sides of her neck. Histological evaluation of a wart-like lesion shows features of AKV, a verruca plana–like histopathology and focal acantholytic dyskeratosis. Forehead biopsy also demonstrated focal acantholytic dyskeratosis supporting the diagnosis of DD. Polymerase chain reaction for human papillomavirus (HPV) DNA detected HPV-17, a human betapapillomavirus in the verruca plana–like papule. Cytoplasmic expression of the L1 capsid expression was seen in areas of hypergranulosis. The presence of productive betaPV infection in the setting of DD and AKV suggests a susceptibility to HPV infection.
*Divisions of Dermatopathology and Dermatology, Department of Pathology, Albany Medical College, Albany, NY;
†Division of Dermatology, Upper Hudson Valley Dermatology, Castleton, NY; and
‡Departments of Dermatology, Microbiology/Medical Genetics, and Internal Medicine, University of Texas Health Science Center, Houston, TX.
Reprints: J. A. Carlson, MD, FRCPC, Division of Dermatopathology and Dermatology, Albany Medical College, MC-81, Albany, NY 12208 (e-mail: firstname.lastname@example.org).
The authors declare no conflicts of interest.
IRB approval: The Committee on Human Research from the University of Texas Health Science Center granted approval for this study originally entitled “Biomarkers for HPV Infection,” number HSC-MS-04-124. This study covers archival paraffin blocks.