Gougerot and Carteaud was the first, in 1927, to describe the rare condition of confluent and reticulated papillomatosis. The name arises from the typical clinical and microscopic appearance of the rash.how confluent reticulated papillomatosis treated
What is the Cause of Confluent and Reticulate Papillomatosis?
The exact cause of confluent and reticulated papillomatosis (CRP) has not been delineated yet, but there is a strong evidence of an infectious cause. Positive response to antibacterial treatment is seen in most patients, favoring a bacterial origin; but no bacteria have been conclusively incriminated so far in confluent reticulated papillomatosis.
An abnormal tissue reaction to Pityrosporum orbiculare, the yeast responsible for Pityriasis versicolor, has also been suggested a cause for CRP.
In some, CRP has been found to occur in association with thyroid disease and diabetes.
What are the Clinical Features of Confluent and Reticulate Papillomatosis?
The rashes appear as dry, gray brown patches of about one to five milimetres in size. The surface has a distinct craggy or crumpled and rough appearance. Enlarging rashes merge towards the center and form a network like morphology towards the periphery; hence the name "confluent and reticulate." Papillomatosis denotes the elongation of the epidermal layers (rete pegs) into the dermal layer of the skin.
Females are more affected than males in confluent and reticulated papillomatosis. Dark-skinned individuals are more prone than the white. The rash usually starts in the mid-chest or between the shoulder blades in the back. Later, these may spread to the neck, upper abdomen and the armpits. The color may be gray brown, dark brown or reddish brown.
How is Confluent and Reticulate Papillomatosis Treated?
Like the debate about the cause of the disease, treatment modalities for confluent and reticulated papillomatosis are also unsatisfactory.
Following are the treatments reported to be useful in confluent reticulated papillomatosis:
- The best combination of treatment is that of an antibiotic plus a topical tretinoin.
- Antibiotics found to be effective are minocycline, doxycycline and azithromycin, in varying doses for a period of two to three weeks.
- Systemic and topical antifungals, though effective in some, produces unpredictable results in majority of cases.
- Calcipotriol topical application has been reported to be effective in some cases.
- In very severe cases, oral retinoids produce good results, but the side effects restrict their use in most people.
Reference:
- Judge MR, McLean WHI, Munro CS. Disorders of Keratinization. In Rook’s Textbook of Dermatology, 7th Edition, 2004
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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