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Keratosis Follicularis. Presented by Irwin Kantor, MD.
A 32-year-old man has a 20-year history of follicular hyperkeratotic lesions involving face, neck, shoulders, trunk, and lower extremities. Papillomatous hyperkeratotic lesions were noted on the dorsa of both feet and toes. The patient had been hospitalized in 1962 with no improvement, and again in 1966 when he was treated with vitamin A and soaks. Results were only fair. Routine laboratory tests were within normal limits. Biopsy was compatible with Darier's disease.
Discussion
Dr. Charles P. DeFeo: At the last Atlantic Dermatological Conference, in Baltimore, methotrexate was used in a 10-year-old boy. Before and after pictures showed spectacular results with comparatively small amounts of methotrexate in the range normally given for psoriasis.Dr. Harry Shatin: As regards the vitamin A therapy, I would suggest dosages of the order of 300,000 to 400,000 units a day. This is in the toxic zone but very