Isotretinoin as a treatment for axillary granular parakeratosis

Granular parakeratosis is a condition presenting with hyperkeratotic plaques and papules that are confined to intertriginous body sites. The exact etiology is unknown, but chemical and mechanical irritation and a moist environment are potential factors. Numerous treatments have been attempted, yielding variable results. We present a case of axillary granular parakeratosis, previously unresponsive to topical treatment, that resolved after a 2-week regimen of isotretinoin. We conclude that treatment of axillary granular parakeratosis with isotretinoin is rapid and effective and should be considered in patients with no other contraindications to isotretinoin.