What’s New in the Medicine Chest: Darier disease

James Del Rosso, DO, a clinical dermatologist and researcher based in Las Vegas, Nevada, recently provided insight into the management of Darier disease, a rare inherited skin disorder, in a presentation at Winter Clinical Miami. In an interview with Dermatology Times on the talk, Del Rosso explained that patients with Darier disease experience painful skin lesions, crusting, and separation, often leading to secondary infections like staphylococcal infections. The condition is notoriously difficult to treat due to its diffuse nature and resistance to standard therapies.

Recent advances in understanding the disease have led researchers to explore the role of type 2 inflammation in its pathology. “There was reason to believe that type 2 inflammation and inhibition of type 2 inflammation would be helpful,” Del Rosso said. Type 2 inflammation involves cytokines such as interleukin 4 (IL-4) and interleukin 13 (IL-13), which play key roles in allergic responses and certain skin conditions. Del Rosso notes promising case reports involving the use of biologic therapies that target this inflammatory pathway.

Del Rosso noted 2 specific drugs, dupilumab and tralokinumab, have shown potential in treating Darier disease. Dupilumab inhibits both IL-4 and IL-13, while tralokinumab targets IL-13 alone. In case studies, these medications have led to significant improvements in patients, with progressive healing observed over 6 to 7 months, though full clearance of lesions was not always achieved. These findings suggest that inhibiting type 2 inflammation may offer a valuable treatment approach for Darier disease.

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Click here for more insights from Del Rosso, including the full interview with Dermatology Times on his presentation at Winter Clinical 2025.