Two-six mm. verrucous, keratotic, or flat-topped papules on the perianal, vulvar, or upper thigh area are characteristic of papular acantholytic dyskeratosis (PAD). One of my patients--an adult woman--had multiple 2-3 mm papules from the ankles to the groin. Some people group this entity with Hailey-Hailey disease.


The patient may be reassured this is a benign condition. The avoidance of tight clothes and sweat, if applicable, is appropriate. Moisturization may help. More aggressive interventions include topical retinoid therapy (e.g., tretinoin 0.05% QHS), topical steroids, topical tacrolimus, and laser.


Australasian Journal of Dermatology (2015) 56, 44–46

PAD in a 41-year-old woman. Dermatology Online Journal 21(5)


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