Mild cases present clinically are minor rashes (without odor) that can become exacerbated by heat, humidity, stress, and sunlight. The symptoms of the disease are thought to be caused by an abnormality in the desmosome-keratin filament complex leading to a breakdown in cell adhesion. Dariers disease is an incommunicable disorder that is seen in males and females equally. Symptoms typically arise between the ages of 15 and 30. One study of 100 British individuals diagnosed with Dariers disease reported that affected individuals display elevated frequencies of neuropsychiatric conditions. There were high lifetime rates for mood disorders (50%), including depression (30%), bipolar disorder (4%), suicidal thoughts (31%), and suicide attempts (13%), suggesting a possible common genetic link. Several case studies have suggested affected populations display elevated frequencies of learning disorders, but this has yet to be confirmed. Treatment
Treatment of Darier disease depends on the severity of the presented clinical symptoms. In most minor cases, the disorder can be managed using sunscreen, moisturizing lotions, avoidance of non-breathable clothing, and excessive perspiration. In more severe cases of Dariers disease, hospitalisation may be required to heal affected individuals who display frequent relapse and remit patterns. In less severe cases, signs and symptoms may clear up completely through hygienic interventions. Most patients with Dariers disease live normal, healthy lives. Rapid resolution of rash symptoms can be complicated due to the increased vulnerability of affected skin surfaces by secondary bacterial or viral infections. Epidermal Staphylococcus aureus, human papillomavirus (HPV) and herpes simplex virus (HSV) infections have been reported.
In these cases, topical and/or oral antibiotic/antiviral medications may need to be prescribed.Typical recommendations are:

Application of antiseptics
Soak in astringents
Antibiotics
Benzoyl peroxide
Topical diclofenac sodiumIf Dariers is more localized, common treatments include:
Topical retinoids: used to help in the reduction of hyperkeratosis, retinoids work by causing the skin cells in the top layers to die and be shed off. The common retinoids used for this disorder are:
Adapalene
Tazarotene gel
Tretinoin
Dermabrasion
Removal of the top layer of skin to help smooth and stimulate new growth of the skin. Electrosurgery
Used to help stop bleeding and remove abnormal skin growths. Topical corticosteroidsIf symptoms are severe, oral retinoids be prescribed and have been proven to be 90% effective. However, there can be many adverse side-effects associated with prolonged use. Common oral retinoids are:

Acitretin
Isotretinoin
CyclosporineSome patients are able to prevent flares with use of topical sunscreens and oral vitamin C.Further information on and advocacy work for Dariers disease are provided by the FIRST Skin Foundation. Epidemiology
Worldwide prevalence is estimated as between 1:30,000 and 1:100,000. Case studies have shown estimated prevalence by country to be 3.8:100,000 in Slovenia, 1:36,000 in north-east England, 1:30,000 in Scotland, and 1:100,000 in Denmark. History
Dariers disease was first described in a paper from 1917 by the dermatologist Ferdinand-Jean Darier in the French dermatological journal Annales de dermatologie et de syphilographie. Darier was a well-regarded dermatologist of the time who was the head of the medical department at the Hôpital Saint-Louis. Darier was an early proponent of histopathology, or the examination of samples of diseased flesh under a microscope to determine the cause of illnesses.