By Gary M. White, MD
Dowling-Degos disease (DDD), also known as "reticulate pigmented anomaly of the flexures," is a rare, reticulated pigmentary disorder usually caused by mutations in keratin 5.
- Onset is often in the 20's and 30's, and an AD inheritance with variable penetrance as well as sporadic cases occur.
- Females are more commonly affected.
- Likes the inverse areas, axilla, inguinal, and inframammary.
- See also Galli-Galli disease.
Reticulated hyperpigmented macules occur in the axillary, inguinal, and inframammary areas. Rarely, the wrists, face, scalp, scrotum, and vulva may be affected. Comedone-like lesions, pruritus, and pitted perioral scars are common features [JAAD 1999;40;462]. Patients often come in complaining of the comedones.
Topical adapalene gel BID was quite helpful in one case [Dermatology 1999;198;176]. Topical tretinoin, hydroquinone, topical steroids, and systemic retinoids have been tried but are usually ineffective.
A Case of Dowling-Degos Disease on the Vulva. Ann Dermatol. 2011 May;23(2):205-208
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