An 8-year-old girl with familial dirty warty papules

Sir, Darier disease is a rare clinical genodermatosis due to abnormalities in intracellular calcium signalling. It is not very common in our part of the world. An 8-yearold girl presented with multiple asymptomatic dirty warty greasy papules on face and upper trunk for 2 years. At first, she developed dirty papules on face. Soon, similar lesions appeared over neck and upper chest. The lesions used to completely disappear in winter, only to reappear in summer. Many family members, including her father and siblings, 6-year and 4-year old, had similar lesions. Lesions were severe and persistent in older members. On examination, multiple dirty warty papules were noted on face (especially along hair line), neck and upper chest (Figure 1). At places, papules coalesced to form greasy plaque. Palms showed small pitting; scalp, mucosa and nails were not involved. Based on clinical presentation and family history, diagnosis of Darier disease was made. Histopathology was consistent with the diagnosis.