Acrokeratosis verruciformis Hopf als minimalvariante des M. Darier

Wart-like hyperkeratoses on the back of the hands and feet belong to the clinical picture of acrokeratosis verruciformis Hopf as well as of dyskeratosis follicularis Darier. The diagnosis of Darier's disease can be made easily when classic sites of predilection are affected. In case of an isolated acral involvement, clinical differentiation between acrokeratosis verruciformis and Darier's disease seems impossible. An acantholytic histology has been proposed to be the only distinct finding. We report a patient with a 20-years history of acrokeratosis verruciformis exhibiting no acantholytic dyskeratosis, who developed clinically and histologically diagnostic lesions of Darier's disease after UV-light provocation. This case supports the notion that acrokeratosis verruciformis does represent a mild presentation of Darier's disease and not an entity by its own.