Intertriginous acantholytic dyskeratosis: abortive form of Darier disease or a specific entity?

A 69-year-old woman presented with widespread symmetrical papular lesions i n submammary and inguinal areas. History revealed that the disease had only been present for a few years. A skin biopsy showed focal suprabasal acanth olysis, dyskeratosis up to the horny layer and in part parakeratotic hyperk eratosis. The patient had no further evidence for Darier disease, Hailey-Ha iley disease or pemphigus vegetans. In particular, characteristic lesions o f Darier disease of hands and nails were absent. We found several reports i n the literature describing similar skin lesions in intertriginous and geni tal areas with histological evidence of acantholytic dyskeratosis under var ious terms. This report discusses the difference between these cases and th e differential diagnoses, in particular Darier disease. We propose to desig nate cases of intertriginous papulosis with histological proof of acantholy tic dyskeratosis but without further evidence of Darier disease as intertri ginous acantholytic dyskeratosis.