Confluent and Reticulated Papillomatosis of Carteaud and Gougerot in a Young Nepali Male

Abstract

Confluent and reticulated papillomatosis of Carteaud and Gougerot is a keratinization disorder with an infective aetiology. Patients present with hyperpigmented papules on the upper trunk and axillae that coalesce centrally and demonstrate reticulation peripherally. Diagnosis is based on clinical findings, characteristic histopathologic changes and response to therapy. We report a case of a young Nepali male who presented with gradual onset of asymptomatic raised dark brown lesions on his neck, trunk and axillae over the course of eight years. The condition was previously misdiagnosed as pityriasis versicolor and had received oral and topical antifungals. The diagnosis was revised to confluent and reticulated papillomatosis based on clinical and histopathological examination. He was subsequently started on oral minocycline 50 mg twice daily and nightly application of topical tretinoin 0.05% gel. There was complete resolution of all his lesions except for residual hyperpigmentation at the end of two months of therapy. There has been no relapse six months from the end of therapy. This is to our knowledge, the first case of confluent and reticulated papillomatosis reported from Nepal. Oral minocycline and topical tretinoin should be considered first line in the treatment of confluent and reticulated papillomatosis.

Confluent and Reticulated Papillomatosis Successfully Treated with Topical Vitamin A Derivative

“…Dowling-Degos disease was not favored as it usually presents as reticulated hyperpigmentation without papules or plaques and presents with a family history of similar lesions. Darier disease was ruled out due to the absence of oral, nail, palmoplantar changes, and the lack of suprabasal acantholysis and dyskeratotic cells in histopathology, in addition to the absence of family history [4,10].…”

Confluent and reticulated papillomatosis treated with extended-release minocycline

“…This resulted in complete subsidence of lesions after two months of treatment and maintained remission for six months. [ 4 ]…”