Bullous Darier's disease

A 50-year-old woman, with multiple, hyperkeratotic, brown papules on the so-called seborrheic areas of the body, had had vesicles and bullae on the inner aspects of the lower extremities and the flexor aspects of the upper extremities each summer since childhood. Her father, brother, and daughter had similar papular lesions. Histologically, suprabasilar lacunae and dyskeratosis of epidermal cells were observed in the hyperkeratotic papules as well as in the vesicular and bullous lesions. The major difference between the histologic features of the hyperkeratotic papules and those of the vesicles or bullae was the size of the lacunae.