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Journal of Hand Surgery (British and European Volume)
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Articles

Darier’s Disease, An Unusual Problem and Solution

A. P. SPROWSON
S. L. A. JEFFERY
M. J. M. BLACK

From the Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, University of Newcastle, Newcastle upon Tyne, UK

Correspondence: Mr Andrew Philip Sprowson, 52 Warkworth Woods, Newcastle Great Park, Gosforth, Newcastle upon Tyne, NE3 5RA, UK. Tel.: +44-191-236-2628; E-mail address: apsprowson{at}doctors.org.uk

A 46-year-old woman with Darier’s disease was referred suffering from severe nail involvement. The patient suffered constant nail infections and an intolerable cycle of progressively more deformity.

On examination the patient’s nails and nail folds were badly deformed.

Initially, as a test, a procedure was undertaken on the thumb alone. The operation was performed under tourniquet control with a digital nerve block. An eponychial flap was raised and nail complex excised. A full thickness skin graft was obtained from the groin. This was sutured into place with the proximal border of graft tucked under the eponychial fold. The results were excellent both surgically and cosmetically.

Subsequently, procedures were performed on the remaining nine digits.

Darier’s disease is extremely variable in its degree of nail involvement. This case highlights a surgical intervention that may help people with intractable associated nail disease.

Key Words: Darier’s • nail • skin graft

Journal of Hand Surgery (British and European Volume), Vol. 29, No. 3, 291-293 (2004)
DOI: 10.1016/J.JHSB.2003.12.005
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