Case report of Darier disease localized to the vulva in a 5-year-old girl.

A 5-year-old girl with Darier disease had numerous verrucous papules coalescing into plaques on both labia majora of approximately one year's duration. She was diagnosed as having genital warts, raising the suspicion of sexual abuse. Subsequently, a biopsy specimen from one of the vulvar lesions revealed histologic characteristics consistent with a diagnosis of Darier disease. The case is unusual for the age of onset and the site of initial involvement, and stresses the importance of including acantholytic disorders such as Darier disease in the differential diagnosis of a child with clinically verrucous lesions.