Line‐field confocal optical coherence tomography of Darier's disease: A case series with histopathological correlation

Dear Editor, Darier's disease is an autosomal dominant genodermatosis caused by mutations in the ATP2A2 gene with the result of impaired keratinocytes adhesion and clinically characterized by rough, greasy, skincoloured or yellowish/brownish papules, commonly involving the seborrhoeic areas of the trunk, neck and flexures. Lesions have a chronic relapsing course, although spontaneous remissions can occur. Clinical manifestations usually first appear between 6 and 20 years, but the disease may present in older age. Aggravating factors include friction, heat, sweating and sunlight. The diagnosis is often clinical, and histopathological confirmation is required. Gene sequencing for ATP2A2 is diagnostic but not routinely performed. In the last years, some noninvasive diagnostic techniques have been reported to aid in the diagnosis of Darier's disease including dermoscopy and reflectance confocal microscopy (RCM).1 Recently, linefield confocal optical coherence tomography (LCOCT), a novel imaging technique for realtime, highresolution, vertical and horizontal skin imaging from the stratum corneum to the dermis, has been introduced in the dermatologic armamentarium, showing its usefulness in the diagnosis of several infectious, neoplastic and inflammatory diseases.2– 10