Authors: Alyssa Joyce L. Cuadra, MD, Audi, MD, Elizabeth Ryan, MD, Leilani Senador, MD


Introduction: Confluent and Reticulated Papillomatosis is a rare disease seen in young adults characterized by persistent brown scaly papules that are confluent in the center and reticulated in the periphery distributed mainly on the neck, upper trunk and axillae. It is an acquired Ichthyosiform dermatosis. Misdiagnosis is frequent for it resembles lesions like that of Tinea Versicolor. Different treatment approaches have been use such as keratolytics and antibiotics. But Minocycline is still the first-line of treatment supporting that the condition is caused by an infection or inflammation.

Case summary: We present a case of a 23-year old male, with sudden onset of multiple, pruritic, hyperpigmented macules and scaly plaques on the back, chest and shoulder. Initially treated as a case of Tinea Versicolor given antifungal cream with no improvement noted. KOH smear was negative. PAS showed negative fungal elements and GAS was negative. Biopsy revealed Confluent and Reticulated Papillomatosis. Doxycycline 100mg/capsule once a day for 4 weeks was started. There was noted complete clearance of the lesions after 4 weeks of treatment.

Conclusion: Confluent and Reticulated Papillomatosis is a rare disease with unknown etiology. Misdiagnosis is common thus a high index of suspicion is needed for initiation of prompt treatment. Antibiotics were shown to be efficacious due to its antibacterial and anti-inflammatory effects supporting claims that it is caused by an infection. The use of Doxycycline as an alternative treatment to the 1st line Minocycline is promising because of its accessibility and cost-effectiveness with comparable side effects.





Confluent and Reticulated Papillomatosis of Gougerot and Carteaud, Doxycycline

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