Of zebras and horses: A 34-year old male with confluent and reticulated papillomatosis

Authors: Athena Emmanuelle M. Parro, MD, Patricia Anne Nicole Ramirez- Ecarma, MD, Arunee H. Sirpunvarapon- Dela Cruz, MD, FPDS

Abstract

Introduction: Confluent and reticulated papillomatosis (CARP), also known as Gougerout-Carteaud Syndrome, is a rare disease affecting young adults. It is often characterized by asymptomatic hyperpigmented papules coalescing into confluent patches and plaques centrally and exhibiting a reticular pattern peripherally. To demonstrate its rarity, only 39 patients were identified in a retrospective review collected from 1972 to 2003 at the Mayo Clinic and only 29 patients in a span of 21 years were identified at the National Skin Center, Singapore. No patients were reported to have the disease here in the Philippines.

Case Summary: This is a rare case of a 34-year old Filipino male who presented with a 2-year history of progressively expanding, asymptomatic hyperpigmented confluent and reticulated papules and plaques on the chest and bilateral frontotemporal area. The patient had no history of inflammatory lesions on the area, application of new products nor any systemic symptoms noted prior to the appearance of the lesions. Skin punch biopsy revealed a non-specific finding of hyperkeratosis, acanthosis and papillomatosis. The patient responded well to Minocycline 100mg/tab OD and application of Tretinoin 0.05% cream twice daily with a significant decrease in size and hyperpigmentation of the lesion after 8 weeks of treatment.

Conclusion: The etiology of CARP remains to be unknown and there is no clear consensus on the pathogenesis and trigger for the disease. However, confluent and reticulated papillomatosis is a benign disease that has good prognosis with excellent response to Minocycline. This case report could shed light to both patients and doctors that it is indeed possible to treat skin diseases with a controversial etiology and non-specific biopsy findings.

 

Citation

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Keywords

Confluent and reticulated papillomatosis, Gougerot- Carteaud Syndrome, CARP
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