Dowling-Degos disease with asymmetrical axillary distribution and no KRT 5 exon 1 mutation.

Sir, Dowling-Degos disease (DDD) is a rare disorder characterized by acquired pigmented macules and papules in a reticulate pattern, particularly affecting the flexural areas and other major skin folds (1, 2). A female patient presented with dotted and reticulate pigmentation of the axilla, and was diagnosed as DDD both clinically and histopathologically. However, the asymmetrical distribution of the eruption was distinct from classical DDD. In contrast to recent reports in Caucasian patients with DDD (3, 4), we found no evidence of mutation of exon 1 of the keratin 5 (KRT5) gene, suggesting an aetiological heterogeneity of this disorder.