Ann Dermatol.  2018 Oct;30(5):550-555. 10.5021/ad.2018.30.5.550.

Clinical and Histopathologic Study of Confluent and Reticulated Papillomatosis by Anatomic Site and Age

• Cho YM
• Jung KE
• Koo DW
• Lee JS

• KMID: 2419744
• DOI: http://doi.org/10.5021/ad.2018.30.5.550

Abstract

BACKGROUND
Confluent and reticulated papillomatosis (CRP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. Few studies regarding this have been reported in the literature.
OBJECTIVE
The purpose of this study was to investigate the clinical and histologic characteristics of CRP in Korean patients according to anatomic site and age.
METHODS
We retrospectively reviewed the medical records, clinical photographs, and 40 histopathologic slides of 29 patients diagnosed with CRP.
RESULTS
Sixteen adults and 13 adolescents were included. The predominantly involved anatomic sites were the trunk (89.7%) and axillae (27.6%); flexural area involvement was mainly found in the adolescent group. The mean disease duration was 2.3 times longer in the adult group than in the adolescent group. The histopathologic features included hyperkeratosis (95.0%), acanthosis (87.5%), and papillomatosis (77.5%) in the epidermis. In the adult group, only 10 specimens (52.6%) showed mild to moderate papillomatosis. There was no relationship between the histologic findings and disease duration; however, the former was associated with the anatomic site.
CONCLUSION
The present study is the first to present the clinical and histologic features of CRP according to age and anatomic site in Korean patients. The patients in this study more frequently had fungal infections (31%) than patients in a previous study (12.8%). Histologic changes were more prominent in the adolescent group than in the adult group and in the flexural area than in the non-flexural area.

Keyword

Confluent and reticulated papillomatosis; Histopathology; Korean patients

MeSH Terms

Adolescent
Adult
Axilla
Epidermis
Humans
Medical Records
Papilloma*
Retrospective Studies
Skin Diseases

Figure

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  Fig. 1 (A) A 23-year-old woman presented with brownish-to-erythematous, reticulated scaly patches and plaques on both sides of the lower abdomen. (B) A 21-year-old man presented with brown reticulated scaly patches and plaques on the lower back and both sides of the axillae.

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  Fig. 2 (A) Histopathologic findings of a biopsy specimen from the abdomen showed an epidermal change (H&E, ×40). (B) Hyperkeratosis and papillomatosis are remarkably seen (H&E, ×100).

Reference

1. Gougerot H, Carteaud A. Papillomatose pigmentée innominée. Bull Soc Fr Dermatol Syphiligr. 1927; 34:719–721.

2. Wise F, Sachs W. Cutaneous papillomatosis: papillomatose confluente et reticulee. Arch Derm Syphilol. 1937; 36:475–485.

3. Thomsen K. Confluent and reticulated papillomatosis (gougerot-carteaud). Acta Derm Venereol Suppl (Stockh). 1979; 59:185–187. PMID: 294095.

4. Groh V, Schnyder UW. Nosology der papillomatose papuleuse confluente et réticulée (gougerot-carteaud). Der Hautarzt. 1983; 34:81–86.

5. Davis MD, Weenig RH, Camilleri MJ. Confluent and reticulate papillomatosis (gougerot-carteaud syndrome): a minocycline-responsive dermatosis without evidence for yeast in pathogenesis. A study of 39 patients and a proposal of diagnostic criteria. Br J Dermatol. 2006; 154:287–293. PMID: 16433798.

6. Lee D, Cho KJ, Hong SK, Seo JK, Hwang SW, Sung HS. Two cases of confluent and reticulated papillomatosis with an unusual location. Acta Derm Venereol. 2009; 89:84–85. PMID: 19197549.

7. Davis RF, Harman KE. Confluent and reticulated papillomatosis successfully treated with amoxicillin. Br J Dermatol. 2007; 156:583–584. PMID: 17300258.

8. Kim MR, Kim SC. Confluent and reticulated papillomatosis on the arm successfully treated with minocycline. J Dermatol. 2010; 37:749–750. PMID: 20649722.

9. Jo S, Park HS, Cho S, Yoon HS. Updated diagnosis criteria for confluent and reticulated papillomatosis: a case report. Ann Dermatol. 2014; 26:409–410. PMID: 24966649.

10. Lee SY, Choi JH, Sung KJ, Moon KC, Koh JK. Confluent and reticulated papillomatosis successfully treated with minocycline. Ann Dermatol. 2000; 12:33–37.

11. Lee SS, Jung NJ, Im M, Lee Y, Seo YJ, Lee JH. Acral-type malignant acanthosis nigricans associated with gastric adenocarcinoma. Ann Dermatol. 2011; 23(Suppl 2):S208–S210. PMID: 22148052.

12. Curth HO. Acanthosis nigricans. Birth Defects Orig Artic Ser. 1971; 7:31–39.

13. Puri N. A study of pathogenesis of acanthosis nigricans and its clinical implications. Indian J Dermatol. 2011; 56:678–683. PMID: 22345770.