Confluent and Reticulated Papillomatosis: A Case with Concurrent Acanthosis nigricans Associated with Obesity and Insulin Resistance

Abstract

A 19-year-old Japanese man with confluent and reticulated papillomatosis (CRP) is presented. He was an obese and dark-complexioned man, who had impaired glucose tolerance and hyperinsulinemia. The clinical and histological findings were consistent with the diagnosis of CRP. He also had acanthosis nigricans (AN) on his axillae and nape. Neither spores nor hyphae were detected from scales; antifungal treatment had no benefit. Although the reduction of his weight was unsuccessful, oral etretinate therapy resulted in considerable improvement of both CRP and AN. We reviewed previous case reports in terms of the relation between CRP and AN. Although the two conditions are usually differentiated because of their distinctive clinical features, a close relationship was noted between CRP and AN.

Three Cases of Concomitant Acanthosis Nigricans with Confluent and Reticulated Papillomatosis in Obese Patients

“…However, a close relationship between the two is suggested by similar predisposing characteristics including young age, obese, dark-skinned persons and parallel response to weight reduction or etretinate therapy 5,6 . A pathogenetic link between the two conditions is suggested by insulin resistance and consequent hyperinsulinemia.…”

“…The presence of underlying endocrinopathies may explain the concurrent CRP and AN in our patients. There have been only two prior reports of concurrent CRP and AN reported in the medical literature 5,6 . However the coexistence of the two diseases is not rare.…”

Combination of Multiple Skin Malignancies with Multiple Endocrine Neoplasia Type 1: Coincidental or Pathogenetically Related?

“…Alternatively, an abnormal host reaction to Pityrosporum orbiculare infection has been discussed [14,15] . Other investigators have reported an association between confluent and reticulated papillomatosis and acanthosis nigricans [19,20] . As the 2 disorders are identical under the microscope and sometimes overlap clinically, there is an ongoing debate as to whether or not they are one and the same disease.…”

Confluent and Reticulated Papillomatosis: Response to Topical Calcipotriol

“…The eti ology is unknown; however, an association with Pityrosporum infection |1, 2], thyroid disease |11, Cushing's syndrome |l |, acantho sis nigricans, impaired glucose tolerance or hyperinsulinemia |2) has been suggested. Also, there is evidence that CRP could be due to 'a genetically determined keratinization defect' [2], Treatment includes retinoids, sele nium sulfide, ketoconazole, erythromycin and tetracycline [1,2].…”

“…skin and soft tissue and genitourinary system [1][2][3][4][5]. The major adverse effects include nausea, abdominal pain and diarrhea.…”