Keratosis follicularis, also called Darier disease, is a slow progressing inherited skin affection that is marked by hyperkeratotic papules. In addition to lesions, there are also nail abnormalities, and mucous membrane changes. This disorder affects both sexes equally and starts to show its symptoms between 6 and 30 years of age.

Symptoms of Keratosis Follicularis

Papules originate from the follicles and interfollicular epidermis. The lesions can develop into skin colored or yellow brown papules with a greasy uneven, or warty texture. The face, ears, chest and back are where they most commonly appear. These keratotic lesions are progressive and can grow larger or spread. Some patients experience periods of remission and relapse of symptoms. Specific characteristics of symptoms as well as periods of change depend on the patient.

People affected experience nail abnormalities which are important for diagnostic reasons. Nails develop red bands and ridges as well as suffer from splitting and sometimes a V-shaped nick at the free margin of the nail. Sometimes hyperkeratoses are seen beneath the nails.

Mucosal lesions form in about 15 percent of patients who suffer from keratosis follicularis. They form as white papules with a depression in the center most commonly found in the mouth. It is possible that oral lesions affect the salivary glands and cause obstruction.

Treatment for Keratosis Follicularis

Sunblock, cool loose clothing, and avoiding exposure to hot area and sun exposure can help prevent breakouts. Lubricating creams with urea or lactic acid can help with scaling and hyperkeratosis. For inflammation, a topical mid-potency steroid can help. There are also some topical prescription creams, injections, and oral medications that can also significantly relieve uncomfortable symptoms associated with follicular keratosis.

For more serious cases, surgical options are also offered. Electrosurgery is more commonly used to treat localized keratosis follicularis. There are also newer procedures being done using carbon dioxide lasers to put lesions into remission phase. A more long lasting fix is combination therapy using carbon dioxide lasers as well as dermabrasion, curettage, and shaving away the lesions. Combination treatments can keep your symptoms at bay for up to 2 years. Photodynamic therapy consists of acid therapy proven to be effective in about 69 percent of patients, and can put symptoms in remission for up to 3 years.