BROWN PAPULES AND LEUKODERMA IN DARIERS-DISEASE - CLINICAL AND HISTOLOGICAL FEATURES

We report a Japanese case of Darier's disease with brown and white pap ules or maculae distributed on the neck, trunk and dorsa of hands. Bot h brown papules and leukoderma showed typical histological features of Darier's disease. Moreover, there were much fewer melanocytes and mel anosomes in the epidermis of both lesions. The corneal layer of the br own papules was far thicker than that of the leukoderma. Therefore, th e thick corneal layer of the brown papules may prolong the retention o f a few melanosomes or a little melanin to induce hyperpigmentation, w hile the thin corneal layer of leukoderma may not do so, thereby produ cing hypopigmentation. The difference in clinical and histological cou rses after involvement of melanocytes was proposed to be the cause of the discrepancy between the previous reports. We conclude that leukode rma was the primary lesion, the postinflammatory depigmented spots, or the atypical or subclinical eruption of Darier's disease.