title: Kaposi varicelliform eruption in patients with Darier disease: a 20-year retrospective study.
abstract: BACKGROUND
  Kaposi varicelliform eruption (KVE), or herpes simplex virus (HSV) superinfection of pre-existing skin lesions, may complicate Darier disease.
  
  
  OBJECTIVE
  We sought to compare the clinical features and outcomes of patients with Darier disease who developed KVE superinfection with those who did not.
  
  
  METHODS
  A 20-year retrospective analysis of 79 patients with Darier disease treated at our institution was performed.
  
  
  RESULTS
  Eleven (14%) patients developed KVE, of whom 45% required hospitalization for their skin disease during the follow-up period. Patients with KVE had more severe Darier disease (P = .030) and were more likely to be hospitalized (P = .015). HSV was detected in erosions without concomitant vesicles or pustules in 64% of confirmed cases. In all, 23 (55%) patients with erosions had HSV testing pursued.
  
  
  CONCLUSIONS
  Retrospective study design is a limitation.
  
  
  CONCLUSIONS
  The majority of KVE occurs in painless or painful erosions that may also appear impetiginized without vesicle or pustule formation. As HSV superinfection is correlated with severe Darier disease and risk for hospitalization, increased recognition of this phenomenon may lead to better patient outcomes.
authors.affiliation: University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
authors.forename: Kaitlin A
authors.initials: KA
authors.lastname: Vogt
authors.affiliation: Department of Statistics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rokea A
authors.initials: RA
authors.lastname: El-Azhary
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Gibson
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota. Electronic address: Lehman.Julia@mayo.edu.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Lehman
mesh_terms: D000328:Adult; D007644:Darier Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007617:Kaposi Varicelliform Eruption / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
keywords: Darier disease; Kaposi varicelliform eruption; erosion; genodermatoses; herpes simplex virus; vesicle