Darier disease: Current insights and challenges in pathogenesis and management.

Autor: Ettinger M; Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria.; Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria., Kimeswenger S; Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria., Deli I; Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria.; Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria., Traxler J; Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria., Altrichter S; Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria.; Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria., Noack P; Institute of Pathology and Molecular Pathology, Kepler University Hospital Linz, Linz, Austria.; Institute of Pathology and Molecular Pathology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria., Wikstrom JD; Dermatology and Venereology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden., Guenova E; Department of Dermatology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.; Department of Dermatology, Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain., Hoetzenecker W; Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria.; Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
Jazyk: angličtina
Zdroj: Journal of the European Academy of Dermatology and Venereology : JEADV [J Eur Acad Dermatol Venereol] 2024 Nov 28. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1111/jdv.20448
Abstrakt: Darier disease is a rare autosomal dominant genodermatosis caused by mutations in the ATP2A2 gene encoding for sarcoendoplasmic reticulum Ca 2+ ATPase isoform 2. The skin disease is characterized by a chronic relapsing course with recurrent reddish-brown keratotic papules and plaques located mainly in seborrhoeic areas. Due to chronic inflammation and epidermal barrier defects of the skin, patients often develop severe bacterial and viral superinfections. Therapeutic options are limited, mainly symptomatic and in most cases unsatisfactory in the long term. Patients are advised to avoid aggravating factors such as high temperature, high humidity, UV radiation and mechanical irritation. To prevent superinfection, antiseptics and periodic use of topical corticosteroids are fundamental in treatment. In case of bacterial and viral superinfection, systemic anti-infective therapy is often necessary. Currently, the most effective treatment option for extensive and persistent skin lesions is systemic retinoids, which are thought to mainly target the epidermal compartment (e.g. by reducing hyperkeratosis). One hallmark of Darier disease patients is chronic skin inflammation. We and others have previously reported Th17 cells in the dermal infiltrate of inflamed Darier disease skin. Counteracting inflammation by blocking the IL-23/IL-17 axis improved skin manifestations in a small cohort of previously therapy-resistant patients over 1 year. Furthermore, several other topical treatment options for mild disease as well as various ablative therapies and surgical excision have been proposed to be effective in some patients with hypertrophic skin lesions. This article aims to outline the pathogenesis, clinical features, diagnosis/differential diagnosis and available treatment modalities of Darier disease.
(© 2024 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
Databáze: MEDLINE
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