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Darier's disease (DD) is a rare autosomal dominant genodermatosis that results from a pathogenic variant in ATP2A2, the gene that encodes sarco/endoplasmic reticulum ATPase type 2 (SERCA2). 1 Patients usually present with keratotic eruptions in the seborrheic regions that may be vesicular or pustular and are associated with itching and discomfort. Acantholytic dyskeratosis is the characteristic histological feature. Treatment usually involves oral retinoids, which are considered symptomatic rather than curative. 2 DD could be considered a relapsing-remitting disease, and exacerbations are known to occur. Common triggers include heat, sweat, and physical trauma, such as from clothing. Here, we suggest that both COVID-19 infection and COVID-19 vaccination should be considered other common and timely triggers for DD exacerbation. | C A SEA previously healthy 30-year-old man presented to the dermatology clinic with a rash. The patient had noticed slight eruptions about 7 years prior, but was not particularly concerned. However, 6 months before he presented to our clinic this time, his skin eruptions exacerbated and increased in number and size just after his second COVID-19 vaccination (mRNA-1273/Spikevax, Moderna), and he had erythematous maculopapular lesions in large areas of the trunk and extremities. 18 months later, he unfortunately developed a COVID-19 infection, after which his skin symptoms worsened again.Clinical examination found large areas of the upper chest, back, neck, nape, and shins to be affected with erythematous maculopapular eruptions (Figure 1a-c). The papules were approximately 2 mm in diameter and were hyperkeratotic and pigmented. Tiny pustules were also seen.

The use of certolizumab pegol to successfully treat generalized pustular psoriasis combined with psoriatic uveitis Dear Editor, Psoriatic uveitis (PsU) is a rare complication of psoriatic arthritis (PsA) and generalized pustular psoriasis (GPP), sometimes triggering major visual loss. The international PsA guidelines indicate that methotrexate, cyclosporine, and tumor necrosis factor (TNF) inhibitors should be used as treatments. 1 Three TNF inhibitors [infliximab, adalimumab, and certolizumab pegol (CZP)] have been approved in Japan. Of these, CZP is the newest; real-world data are sparse. To

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