Pruritic eruption with reticular pigmentation: confluent and reticulate papillomatosis

Clinicopathological and diagnostic characterization of confluent and reticulate papillomatosis of Gougerot and Carteaud: a retrospective study in a South-East Asian population

BACKGROUND

Confluent and reticulate papillomatosis of Gougerot and Carteaud (CRP) is a rare dermatological condition, which has not been reported widely in Asian populations.

AIM

To characterize the clinicopathological and diagnostic features of CRP in a South-East Asian population.

METHODS

The medical records of 29 patients accorded the diagnosis of CRP at the National Skin Centre, Singapore, from 1990 to 2011, were analyzed.

RESULTS

The male to female ratio was 2.6:1. Eight patients were Indians. The mean age at the onset of skin eruptions was 29.1 years (range 16-55 years), while the mean duration was 19.9 months (range 0.5-120 months). CRP itself was the most common preliminary diagnosis. Fungal smears were negative in all 22 instances. All 29 patients had received a trial of antifungal therapy before being seen at our center. Antifungal therapy was repeated in three subjects, and the response was uniformly poor. Conversely, the treatment response with tetracyclines was excellent, yielding more than a 50% response in all 14 patients. Four patients suffered recurrence of CRP. According to the diagnostic criteria set forth by Davis et al., 25/29 patients (86.2%) and 19/29 patients (65.6%) fulfilled at least three and four criteria, respectively.

CONCLUSION

A predilection for male gender and Indian ethnicity were noted in our study. The diagnosis of CRP was often made clinically, and investigations were mainly ancillary. The treatment response was poor with antifungal agents but excellent with tetracyclines. The diagnostic criteria proposed by Davis et al. were found to be useful in our cohort of patients.