Gougerot Carteaud - Een Diepgaande Verkenning van Huidaandoeningen

Unusual Clinical Scenarios to Consider in Patient Management

Be careful to differentiate between widespread and acute onset acanthosis nigricans. which can be a paraneoplastic syndrome, especially when it does not respond to therapy directed at CARP.

Baalbaki, SA, Malak, JA, al-Khars, MA. “Confluent and reticulated papillomatosis. Treatment with etretinate”. Arch Dermatol. vol. 129. 1993. pp. 961-3. (This article describes the use of etretinate in CARP.)

Gonul, M, Cakmak, SK, Soylu, S, Kilic, A, Gul, U, Ergul, G. “Successful treatment of confluent and reticulated papillomatosis with topical mupirocin”. J Eur Acad Dermatol Venereol. vol. 22. 2008. pp. 1140-2. (Bacterial infection may be the cause of CARP mupirocin may be effective for this reason.)

Katayama, I, Yokozeki, H, Nishioka, K. “Oral minocycline improved keratosis follicularis squamosa (Dohi) and reticulated disorders: Bacterial factors are possibly involved in aberrant keratinization”. J Dermatol. vol. 21. 1994. pp. 604-8. (This article discusses the possible bacterial pathophysiology of CARP.)

Henning, JP, de Wit, RF. “Familial occurrence of confluent and reticulated papillomatosis”. Arch Dermatol. vol. 117. 1981. pp. 809-10. (A case of familial CARP.)

Kägi, MK, Trüeb, R, Wüthrich, B, Burg, G. “Confluent and reticulated papillomatosis associated with atopy. Successful treatment with topical urea and tretinoin”. Br J Dermatol. vol. 134. 1996. pp. 381-2. (This article discusses alternate therapies for CARP.)

Kurkcuoglu, N, Celebi, CR. “Confluent and reticulated papillomatosis: response to topical calcipotriol”. Dermatology. vol. 191. 1995. pp. 341-2. (Calcipotriol for CARP.)

Hirokawa, M, Matsumoto, M, Iizuka, H. “Confluent and reticulated papillomatosis: a case with concurrent acanthosis nigricans associated with obesity and insulin resistance”. Dermatology. vol. 188. 1994. pp. 148-51. (This article discusses the possible link between insulin resistance and CARP.)

References

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Who is at Risk for Developing this Disease?

CARP is almost exclusively a disease of postpubertal young adults. It is more easily recognized in dark-skinned people due to the hyperpigmentation but is likely under-recognized in light-skinned people. It is more common in women in the USA but is more common in men in Japanese literature. CARP may be more common in obese patients and those with endocrine disorders such as diabetes mellitus.

There are multiple theories for the pathophysiology and etiology of CARP. CARP has been described more commonly in patients with endocrine disorders such as diabetes mellitus and thyroid disease. Theories for the pathogenesis are listed below.

The histologic hallmark is epidermal thickening with abnormal keratinization with melanosomes, leading to the look of hyperpigmentation. This may be primary or secondary but would explain the response to retinoids and possibly topical vitamin D derivatives.

There are reports of both Dietzia species (an Actinomycete) as well as Staphylococcus aureus but other reports have failed to find organisms on staining of histopathologic specimens

There may be a genetic predisposition, as CARP can run in families, but this could also be observed if there was an infectious or environmental cause

Abstract

Confluent and reticulated papillomatosis (CRP) is an underdiagnosed skin condition of uncertain etiology. The antibacterial and most importantly the anti‐inflammatory mechanisms of some antibiotics seem to explain the effectiveness of these medications. Other measures such as reducing weight and treating an underlying endocrine disorder may be helpful.

Bacterial proliferation and endocrine factors may have synergistic contributions to the development of CRP. Treatment is therefore based on antibiotics but other measures such as reducing weight and screening for endocrine disorders may be useful.

Confluent and Reticulated Papillomatosis of Gougerot-Carteaud on Black Skin: Two Observations

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Confluent and reticulated papillomatosis of Goujerot-Carteaud is a rare and benign skin disease characterized by flat papules taking a reticulated appearance. It is a skin disease of unknown etiology and nosology that is always discussed. This disease preferentially involves the chest and interscapular regions. It is a condition probably underdiagnosed in black skin because it generally simulates a pigmented tinea versicolor. This pathology withstands antifungal treatment but has a particular sensitivity to cyclines thus constituting a distinguishing criterion, useful for diagnosis which should be evoked in front of these reticulated confluent papules.