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JAMA Dermatology Clinicopathological Challenge
April 2017

Papulovesicular Eruption in a Pregnant Woman With Darier Disease

Author Affiliations
  • 1Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
  • 2Division of Dermatology, Cooper Medical School, Rowan University, Camden, New Jersey
  • 3Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
JAMA Dermatol. 2017;153(4):317-318. doi:10.1001/jamadermatol.2016.4189

A primigravida woman in her 30s at 35 weeks’ gestation and with a history of Darier disease was admitted with an acute, painful eruption on her face and neck. She reported no history of pregnancy-related complications. Physical examination revealed confluent erythema with keratotic papulovesicles distributed on the face and neck (Figure, A). Honey-colored crusts were present on the left ear and preauricular area. The chest and inframammary area displayed occasional red, crusted papules. Laboratory tests revealed an elevated white blood cell count of 17.18 × 103/μL (reference range, 4.50-11.00 × 103/μL). A shave biopsy specimen and tissue culture were obtained from the center of an umbilicated papule on the neck (Figure, B and C).

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