Commentary: Darier-White Disease

In 1871, Harvard became the first American university to establish an independent chair of dermatology and James C. White, MD, was the first to occupy it. At that time, dermatology was becoming recognized as a specialty in this country and American dermatology had declared its independence from the European schools. In 1889, White 1 described a case of keratosis (ichthyosis) follicularis, while, independently, Professor Ferdinand Jean Darier, MD, published a similar case in Paris, which he called "psorospermose folliculaire vegetante." 2 From then on, keratosis follicularis, psorospermose folliculaire vegetante, Darier-White disease, or Darier's disease became an accepted entity. The point-by-point, meticulous clinical description of the disorder by White was accurate; however, in this first account, he failed to describe dyskeratotic cells, the histopathologic hallmark of this disorder. He erroneously postulated that the hair follicle was the primary site of involvement. Darier first described the dyskeratotic regions in the epidermis, but