Haber's Syndrome or Dowling-Degos Disease?

To the Editor.—  The report of three cases of Haber's syndrome (HS) in the June 1981 Archives (117:321-324) by Kikuchi et al denigrates Dowling-Degos disease (DDD) as a possible alternative diagnosis.Clinically, the Japanese cases and, in particular, case 2 had axillary, black, verrucous lesions, "open comedo-like or milium-like papules," and "black papules" that closely resemble the dark dots and the diffuse seborrheic keratoses of the flexures of DDD. Dowling-Degos disease does not always have a reticulate pattern, and follicular lesions may well be the main manifestation.¹ Even the histopathologic features shown in the article are strikingly similar to the delicate downgrowths encasing the enlarged follicles of DDD.¹Actually, DDD does not show the central facial telangiectatic erythema described in HS, but facial erythema and burning sensations on wind exposure are not surprising features in youngsters with the dry skin and the "ichthyosis-like lesions over the lower extremities"