array:23 [
  "pii" => "S1578219012001060"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2012.04.010"
  "estado" => "S300"
  "fechaPublicacion" => "2012-04-01"
  "aid" => "496"
  "copyright" => "Elsevier España, S.L. and AEDV"
  "copyrightAnyo" => "2011"
  "documento" => "simple-article"
  "crossmark" => 0
  "subdocumento" => "cor"
  "cita" => "Actas Dermosifiliogr. 2012;103:255-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3353
    "formatos" => array:3 [
      "EPUB" => 54
      "HTML" => 2660
      "PDF" => 639
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731011004613"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2011.09.003"
      "estado" => "S300"
      "fechaPublicacion" => "2012-04-01"
      "aid" => "496"
      "copyright" => "Elsevier España, S.L. y AEDV"
      "documento" => "simple-article"
      "crossmark" => 0
      "subdocumento" => "cor"
      "cita" => "Actas Dermosifiliogr. 2012;103:255-6"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4078
        "formatos" => array:3 [
          "EPUB" => 2
          "HTML" => 3007
          "PDF" => 1069
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta Cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Terapia de contacto corto con tazaroteno t&#243;pico en Darier segmentaria"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "255"
            "paginaFinal" => "256"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Short-Contact Therapy With Topical Tazarotene in Darier disease"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 1171
                "Ancho" => 998
                "Tamanyo" => 125267
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Desaparici&#243;n completa de las lesiones tras un mes de tratamiento con tazaroteno t&#243;pico al 0&#44;1&#37;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "T&#46; Sanz-S&#225;nchez, R&#46;M&#46; D&#237;az-D&#237;az, O&#46; L&#243;pez-Barrantes, R&#46; Valverde-Garrido"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "T&#46;"
                "apellidos" => "Sanz-S&#225;nchez"
              ]
              1 => array:2 [
                "nombre" => "R&#46;M&#46;"
                "apellidos" => "D&#237;az-D&#237;az"
              ]
              2 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "L&#243;pez-Barrantes"
              ]
              3 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Valverde-Garrido"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219012001060"
          "doi" => "10.1016/j.adengl.2012.04.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001060?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011004613?idApp=UINPBA000044"
      "url" => "/00017310/0000010300000003/v1_201304241400/S0001731011004613/v1_201304241400/es/main.assets"
    ]
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219012001059"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2012.04.009"
    "estado" => "S300"
    "fechaPublicacion" => "2012-04-01"
    "aid" => "490"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2012;103:253-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3913
      "formatos" => array:3 [
        "EPUB" => 50
        "HTML" => 3254
        "PDF" => 609
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Systemic Follicular Lymphoma With Cutaneous Manifestations and Exclusively Cutaneous Recurrence"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "253"
          "paginaFinal" => "255"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Linfoma folicular sist&#233;mico con afectaci&#243;n cut&#225;nea y recidiva &#250;nicamente cut&#225;nea"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1338
              "Ancho" => 993
              "Tamanyo" => 389853
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Bcl2<span class="elsevierStyleSup">&#43;</span> lymphoid infiltrate&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Palacios Abuf&#243;n, E&#46; Acebo Mari&#241;as, J&#46; Gardeazabal Garc&#237;a, J&#46;C&#46; Garc&#237;a-Ruiz"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Palacios Abuf&#243;n"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Acebo Mari&#241;as"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gardeazabal Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "Garc&#237;a-Ruiz"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731011004273"
        "doi" => "10.1016/j.ad.2011.06.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011004273?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001059?idApp=UINPBA000044"
    "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012001059/v1_201304241257/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cases and Research Letters</span>"
    "titulo" => "Short-Contact Therapy With Topical Tazarotene in Darier Disease"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "255"
        "paginaFinal" => "256"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "T&#46; Sanz-S&#225;nchez, R&#46;M&#46; D&#237;az-D&#237;az, O&#46; L&#243;pez-Barrantes, R&#46; Valverde-Garrido"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "T&#46;"
            "apellidos" => "Sanz-S&#225;nchez"
            "email" => array:1 [
              0 => "tatiana&#64;aedv&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;M&#46;"
            "apellidos" => "D&#237;az-D&#237;az"
          ]
          2 => array:2 [
            "nombre" => "O&#46;"
            "apellidos" => "L&#243;pez-Barrantes"
          ]
          3 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Valverde-Garrido"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Infanta Sof&#237;a&#44; San Sebasti&#225;n de los Reyes&#44; Madrid&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Terapia de contacto corto con tazaroteno t&#243;pico en Darier segmentaria"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1171
            "Ancho" => 997
            "Tamanyo" => 131154
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Complete disappearance of lesions after 1 month of topical treatment with 0&#46;1&#37; tazarotene&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the clinical science letter by de la Hera and coworkers<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and wish to share our positive experience with topical tazarotene in the treatment of linear Darier disease&#46; Our good results contrast with the weak efficacy and poor tolerance described by those authors&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Mild Darier disease is treated with topical retinoids&#44; although the use of such therapy is limited by local irritation&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Tazarotene is a retinoid indicated for the treatment of psoriasis&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Isolated cases have been reported in which tazarotene was used to treat acne&#44; lichen planus&#44; keratosis pilaris&#44; ichthyosis&#44; confluent and reticulated papillomatosis&#44; keratoderma blennorrhagica&#44; discoid lupus erythematosus&#44; and Darier disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We present the case of a 48 year-old woman with a 20-year history of linear Darier disease&#44; who was being treated with topical corticosteroids&#46; She reported poor control of lesions for a period of over 1 year&#44; prompting her referral to our service&#46; At the time of the consultation the patient presented brownish keratotic lesions on the left side of her forehead&#44; the back and left side of her neck&#44; and her lower back&#46; These clinical signs were indicative of Darier disease and the diagnosis was subsequently confirmed by biopsy and histological analysis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">As the lesions were localized to the areas described&#44; therapy with 0&#46;1&#37; tazarotene was prescribed&#46; The treatment was applied nightly and washed off with water 15<span class="elsevierStyleHsp" style=""></span>minutes after application&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The lesions disappeared after 1 month of treatment &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The neck lesions did not recur during 1 year of follow-up&#44; even during the summer&#46; Lesions in the lumbar and frontal regions persist&#44; although to a lesser degree&#44; and are controlled by the patient with topical tazarotene&#46; The patient reported no irritation at any stage of the treatment&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Tazarotene is a third generation retinoid&#46; This prodrug is rapidly converted by skin esterases to its active metabolite&#44; tazarotenic acid&#46; Systemic exposure to the drug is low due to its rapid metabolism&#46; Its greatest affinity is for the retinoic acid receptors RAR-&#946; and RAR-&#947;&#44; through which it exerts its biological effect&#46; These receptors interact with genes and influence their expression&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Although the mechanism of action of tazarotene in Darier disease is unknown&#44; it may be similar to that underlying its therapeutic effect in the treatment of psoriasis&#44; another differentiation and keratinization disorder&#46; Studies in psoriasis have shown that tazarotene exerts a potent antiproliferative effect by normalizing the differentiation and proliferation of keratinocytes&#46; It also decreases markers of inflammation and regulates cytokine and gene expression by interacting specifically with RAR-&#946; and RAR-&#947; receptors&#46; Analyses of other retinoids in the treatment of Darier disease have also demonstrated altered expression of cytokeratin&#44; which is associated with clinical and histopathological improvements and a reduction in acanthosis and hyperkeratosis&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The irritation described following retinoid use for the treatment of Darier disease may contribute to the appearance of new lesions and discontinuation of treatment due to poor tolerance&#46; This can be avoided by co-application of topical corticosteroids&#44; by reducing the concentration of tazarotene&#44; or by progressively increasing the frequency of tazarotene application&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In the present case&#44; after reviewing the literature&#44; we decided upon short-contact therapy with tazarotene&#44; which involved application of the product followed by its removal 15<span class="elsevierStyleHsp" style=""></span>minutes later&#46; In line with the results reported by some other authors in cases of acne&#44; psoriasis&#44; and Darier disease treated with tazarotene&#44; we observed no irritation and a rapid disappearance of lesions with no side effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The Koebner phenomenon or isomorphic response is characterized by the appearance of specific skin lesions on areas of healthy skin previously exposed to different kinds of trauma or triggers&#44; including ultraviolet radiation&#44; irritation&#44; and friction&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Accordingly&#44; the irritation sometimes caused by tazarotene may provoke an isomorphic phenomenon and may give rise to the appearance of new lesions in Darier disease&#46; Interestingly&#44; the lack of irritation observed with short-contact tazarotene therapy has been previously described&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and may partially explain the continued improvement of our patient&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; we highlight the effectiveness of short-contact therapy with topical tazarotene in the present case and in other cases reported in the literature&#46; We propose it as a simple topical alternative for the treatment of linear or localized Darier disease that is effective&#44; well tolerated&#44; and lacks the potential side effects of oral retinoid treatment&#46; Further studies are needed to obtain a better understanding of the mechanism of action of tazarotene in the treatment of Darier disease&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Sanz-S&#225;nchez T&#44; et al&#46; Terapia de contacto corto con tazaroteno t&#243;pico en Darier segmentaria&#46; Actas Dermosifiliogr&#46; 2012&#59;103&#58;255&#8211;6&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 845
            "Ancho" => 993
            "Tamanyo" => 85516
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple keratotic lesions on the back and side of the neck&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1171
            "Ancho" => 997
            "Tamanyo" => 131154
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Complete disappearance of lesions after 1 month of topical treatment with 0&#46;1&#37; tazarotene&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedad de Darier segmentaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; De la Hera"
                            1 => "R&#46; Chico"
                            2 => "R&#46; Llamas"
                            3 => "F&#46; Vanaclocha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2010.07.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2011"
                        "volumen" => "102"
                        "paginaInicial" => "299"
                        "paginaFinal" => "300"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21288500"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of Darier&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Burge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "1999"
                        "volumen" => "24"
                        "paginaInicial" => "53"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10233651"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n actualizada del tratamiento t&#243;pico de la psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Carrascosa"
                            1 => "F&#46; Vanaclocha"
                            2 => "L&#46; Borrego"
                            3 => "E&#46; Fern&#225;ndez-L&#243;pez"
                            4 => "A&#46; Fuertes"
                            5 => "L&#46; Rodr&#237;guez-Fern&#225;ndez-Freire"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2009"
                        "volumen" => "100"
                        "paginaInicial" => "190"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19457304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tazarotene gel for Darier&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;G&#46; Burkhart"
                            1 => "C&#46;N&#46; Burkhart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1998"
                        "volumen" => "38"
                        "paginaInicial" => "1001"
                        "paginaFinal" => "1002"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9632016"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The treatment of Darier&#39;s disease with topical tazarotene"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Oster-Schmidt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "141"
                        "paginaInicial" => "603"
                        "paginaFinal" => "604"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10583100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tazaroteno&#58; un nuevo retinoide de uso t&#243;pico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Guerra Tapia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "71"
                        "paginaFinal" => "78"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical treatment with 13-cis-retinoic acid improves Darier&#39;s disease and induces the expression of a unique keratin pattern"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;M&#46; Steijlen"
                            1 => "R&#46; Happle"
                            2 => "G&#46;N&#46; van Muijen"
                            3 => "P&#46;C&#46; van de Kerkhof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatologica"
                        "fecha" => "1991"
                        "volumen" => "182"
                        "paginaInicial" => "178"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1715297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-contact therapy with tazarote in psoriasis vulgaris"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Veraldi"
                            1 => "R&#46; Shianchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "69953"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "2003"
                        "volumen" => "206"
                        "paginaInicial" => "347"
                        "paginaFinal" => "348"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12771482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Linear Darier&#39;s disease successfully treated with 0&#46;1&#37; tazarotene gel short-contact therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Brazzelli"
                            1 => "F&#46; Prestinari"
                            2 => "T&#46; Barbagallo"
                            3 => "C&#46; Vassallo"
                            4 => "M&#46; Agozzino"
                            5 => "G&#46; Borroni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Dermatol"
                        "fecha" => "2006"
                        "volumen" => "16"
                        "paginaInicial" => "59"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16436344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Koebner phenomenon"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Sagi"
                            1 => "H&#46; Trau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2010.09.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "231"
                        "paginaFinal" => "236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21396563"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012001060/v1_201304241257/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6169"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Cases and Research Letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000003/v1_201304241257/S1578219012001060/v1_201304241257/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001060?idApp=UINPBA000044"
]
Share
Journal Information
Vol. 103. Issue 3.
Pages 255-256 (April 2012)
Vol. 103. Issue 3.
Pages 255-256 (April 2012)
Cases and Research Letters
Full text access
Short-Contact Therapy With Topical Tazarotene in Darier Disease
Terapia de contacto corto con tazaroteno tópico en Darier segmentaria
Visits
8849
T. Sanz-Sánchez
Corresponding author
tatiana@aedv.es

Corresponding author.
, R.M. Díaz-Díaz, O. López-Barrantes, R. Valverde-Garrido
Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Full Text
To the Editor:

We read with interest the clinical science letter by de la Hera and coworkers1 and wish to share our positive experience with topical tazarotene in the treatment of linear Darier disease. Our good results contrast with the weak efficacy and poor tolerance described by those authors.

Mild Darier disease is treated with topical retinoids, although the use of such therapy is limited by local irritation.2

Tazarotene is a retinoid indicated for the treatment of psoriasis.3 Isolated cases have been reported in which tazarotene was used to treat acne, lichen planus, keratosis pilaris, ichthyosis, confluent and reticulated papillomatosis, keratoderma blennorrhagica, discoid lupus erythematosus, and Darier disease.2,4,5

We present the case of a 48 year-old woman with a 20-year history of linear Darier disease, who was being treated with topical corticosteroids. She reported poor control of lesions for a period of over 1 year, prompting her referral to our service. At the time of the consultation the patient presented brownish keratotic lesions on the left side of her forehead, the back and left side of her neck, and her lower back. These clinical signs were indicative of Darier disease and the diagnosis was subsequently confirmed by biopsy and histological analysis (Fig. 1).

Figure 1.

Multiple keratotic lesions on the back and side of the neck.

(0.08MB).

As the lesions were localized to the areas described, therapy with 0.1% tazarotene was prescribed. The treatment was applied nightly and washed off with water 15minutes after application.

The lesions disappeared after 1 month of treatment (Fig. 2).

Figure 2.

Complete disappearance of lesions after 1 month of topical treatment with 0.1% tazarotene.

(0.13MB).

The neck lesions did not recur during 1 year of follow-up, even during the summer. Lesions in the lumbar and frontal regions persist, although to a lesser degree, and are controlled by the patient with topical tazarotene. The patient reported no irritation at any stage of the treatment.

Tazarotene is a third generation retinoid. This prodrug is rapidly converted by skin esterases to its active metabolite, tazarotenic acid. Systemic exposure to the drug is low due to its rapid metabolism. Its greatest affinity is for the retinoic acid receptors RAR-β and RAR-γ, through which it exerts its biological effect. These receptors interact with genes and influence their expression.6 Although the mechanism of action of tazarotene in Darier disease is unknown, it may be similar to that underlying its therapeutic effect in the treatment of psoriasis, another differentiation and keratinization disorder. Studies in psoriasis have shown that tazarotene exerts a potent antiproliferative effect by normalizing the differentiation and proliferation of keratinocytes. It also decreases markers of inflammation and regulates cytokine and gene expression by interacting specifically with RAR-β and RAR-γ receptors. Analyses of other retinoids in the treatment of Darier disease have also demonstrated altered expression of cytokeratin, which is associated with clinical and histopathological improvements and a reduction in acanthosis and hyperkeratosis.7

The irritation described following retinoid use for the treatment of Darier disease may contribute to the appearance of new lesions and discontinuation of treatment due to poor tolerance. This can be avoided by co-application of topical corticosteroids, by reducing the concentration of tazarotene, or by progressively increasing the frequency of tazarotene application.4,5

In the present case, after reviewing the literature, we decided upon short-contact therapy with tazarotene, which involved application of the product followed by its removal 15minutes later. In line with the results reported by some other authors in cases of acne, psoriasis, and Darier disease treated with tazarotene, we observed no irritation and a rapid disappearance of lesions with no side effects.8,9

The Koebner phenomenon or isomorphic response is characterized by the appearance of specific skin lesions on areas of healthy skin previously exposed to different kinds of trauma or triggers, including ultraviolet radiation, irritation, and friction.10 Accordingly, the irritation sometimes caused by tazarotene may provoke an isomorphic phenomenon and may give rise to the appearance of new lesions in Darier disease. Interestingly, the lack of irritation observed with short-contact tazarotene therapy has been previously described,5 and may partially explain the continued improvement of our patient.

In conclusion, we highlight the effectiveness of short-contact therapy with topical tazarotene in the present case and in other cases reported in the literature. We propose it as a simple topical alternative for the treatment of linear or localized Darier disease that is effective, well tolerated, and lacks the potential side effects of oral retinoid treatment. Further studies are needed to obtain a better understanding of the mechanism of action of tazarotene in the treatment of Darier disease.

References
[1]
I. De la Hera, R. Chico, R. Llamas, F. Vanaclocha.
Enfermedad de Darier segmentaria.
Actas Dermosifiliogr, 102 (2011), pp. 299-300
[2]
S. Burge.
Management of Darier's disease.
Clin Exp Dermatol, 24 (1999), pp. 53-56
[3]
J.M. Carrascosa, F. Vanaclocha, L. Borrego, E. Fernández-López, A. Fuertes, L. Rodríguez-Fernández-Freire, et al.
Revisión actualizada del tratamiento tópico de la psoriasis.
Actas Dermosifiliogr, 100 (2009), pp. 190-200
[4]
C.G. Burkhart, C.N. Burkhart.
Tazarotene gel for Darier's disease.
J Am Acad Dermatol, 38 (1998), pp. 1001-1002
[5]
C. Oster-Schmidt.
The treatment of Darier's disease with topical tazarotene.
Br J Dermatol, 141 (1999), pp. 603-604
[6]
A. Guerra Tapia.
Tazaroteno: un nuevo retinoide de uso tópico.
Actas Dermosifiliogr, 90 (1999), pp. 71-78
[7]
P.M. Steijlen, R. Happle, G.N. van Muijen, P.C. van de Kerkhof.
Topical treatment with 13-cis-retinoic acid improves Darier's disease and induces the expression of a unique keratin pattern.
Dermatologica, 182 (1991), pp. 178-183
[8]
S. Veraldi, R. Shianchi.
Short-contact therapy with tazarote in psoriasis vulgaris.
Dermatology, 206 (2003), pp. 347-348
[9]
V. Brazzelli, F. Prestinari, T. Barbagallo, C. Vassallo, M. Agozzino, G. Borroni.
Linear Darier's disease successfully treated with 0.1% tazarotene gel short-contact therapy.
Eur J Dermatol, 16 (2006), pp. 59-61
[10]
L. Sagi, H. Trau.
The Koebner phenomenon.
Clin Dermatol, 29 (2011), pp. 231-236

Please cite this article as: Sanz-Sánchez T, et al. Terapia de contacto corto con tazaroteno tópico en Darier segmentaria. Actas Dermosifiliogr. 2012;103:255–6.

Copyright © 2011. Elsevier España, S.L. and AEDV
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?