Oral manifestations of Darter's disease: A clinical and pathological study

Patients with Darier's disease may present oral lesions which occur in about 50% of affected patients. The palate, gingiva, buccal mucosa and the tongue are most commonly affected. This study reports the clinical and pathological features of me oral manifestations of Darier's disease. The pathology of early reddish spots reveals ortho-parakeratotic hyperkeratosis with focal hypergranulosis ancl acanthosis. The pathology or established white papules shows the typical features of acantholytic dyskeratosis with suprabasal clefts containing acantholytic ayskeratotic keratinocytes. Our study indicates that although acantholytic dyskeratosis is a pathological marker or established oral lesions of Darier's disease, this pathological feature may not be detectable in early oral spots. The absence of acantholytic dyskeratosis in early lesions is not exclusive to mouth pathology, it has been described in the early nail lesions of patients with Darier's disease. These findings indicate that the absence of acantholytic dyskeratosis should not be considered an absolute criterion for excluding a possible diagnosis of Darier's disease.