We investigated the psychiatric history of patients with severe Darier's disease and a control group, which consisted of patients with comparably severe dermatologic disorders of keratinization. Three patients with Darier's disease reported either a suicide attempt (one patient) or a specific suicide plan (two), compared with one patient in the control group. Of 11 patients with Darier's disease, 7 had a history of suicidal thoughts, compared with 3 of 11 patients in the control group. Thus suicidal ideation is a potential problem in patients with cutaneous illnesses, particularly those with chronic disfiguring disorders such as severe Darier's disease.