Irregular papular lesions of the hard palate

Dental practitioners should be familiar with Darier's disease because oral lesions of the disease may resemble other diseases. Differential diagnosis should include papillary hyperplasia of the palate, acanthosis nigricans, Cowden's disease, nicotine stomatitis, and condyloma acuminatum. Careful observation of the oral and skin lesions and consideration of the medical and family history should assist in diagnosis. Vitamin A, given in high doses, has been used with variable success in the treatment of Darier's disease. Systemic corticosteroids have been used with good results, but these require prolonged use as they are not curative. Secondary infection is a common complication for which topical corticosteroids are helpful.