Xinzhou Liu,1,2 Xiuhuan Wang,1,2 Jianke Li,1,2 Xiaofeng Shan,1,2 Zhongxiang Shi1,2 

1Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Jinan, 250022, People’s Republic of China; 2Department of Dermatology, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, 250022, People’s Republic of China

Correspondence: Zhongxiang Shi, Hospital for Skin Diseases, Shandong First Medical University, Jinan, 250022, People’s Republic of China, Tel +86 (531)87298874, Fax +86-531-87984734, Email szxsd2003@sina.com

Abstract: Darier’s disease (DD) is an autosomal dominant genodermatosis characterized by hyperkeratotic papules, often accompanied by scaling and crusting. Managing DD presents significant challenges due to the absence of an effective cure, with only symptom targeting treatments currently available. This study presents a case of refractory DD that showed poor response to established pharmacological treatments but demonstrated improvement with low-dose superficial X-ray radiotherapy (SRT). The radiation was delivered as a single 200 cGy treatment, which visibly improved the condition. Considering the different degrees of side effects, sequelae, and risk of developing radiation-induced cancer after exposure to moderate levels of radiation, it may be considered that we attempt to treat recalcitrant DD initially by applying a low dose of radiation in order to mitigate these undesired side effects. If larger doses or additional courses are necessary due to inadequate response, the risks and benefits must be carefully evaluated and discussed with patients.

Keywords: Darier disease, superficial X-ray, low-dose of radiation, SRT-100