A case of severe refractory Darier's disease of the feet in which management with carbon dioxide (CO) laser therapy demonstrated superior outcomes to surgical excision.

Darier's disease is a rare genodermatosis typically characterized by scaly or crusted papules. Usual management comprises topical and oral treatments, however medical therapy may be inadequate in cases of severe disease. For these patients, further treatment options may include the use of carbon dioxide (CO) laser therapy or surgical excision with skin grafting. We describe a unique situation in which both CO laser therapy and surgical excision were trialed in comparable areas within a single patient. Superior outcomes over a 7-year follow up period have been seen with the use of CO laser therapy.