Document Detail

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.
MedLine Citation:
PMID:  16433798     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Confluent and reticulate papillomatosis (CRP) (Gougerot-Carteaud syndrome) is a disorder that has been characterized in only small cohorts of patients. OBJECTIVES: Better to characterize the clinical and pathological findings of the disorder. METHODS: We retrospectively reviewed the clinical presentation, response to treatment and histological findings of patients presenting to Mayo Clinic (Rochester, MN, U.S.A.) with CRP. RESULTS: The disorder was diagnosed in 39 patients between 1972 and 2003. Mean age at onset of the skin eruption was 15 years (range 8-32); 21 patients (54%) were male; most were white; most (33) presented for reasons of cosmesis; and eight described the rash as mildly pruritic. At presentation, the skin eruption had been present for a mean of 3.1 years (range 3 months-20 years) and had been recalcitrant to treatment, including antifungal treatment. Typical objective findings were scaling brown macules and patches and velvety papules and plaques, reticulated and papillomatous at least in part, involving the upper trunk, axillae and neck. The most frequent initial diagnostic impressions were tinea versicolor, acanthosis nigricans and CRP. Scales in 32 cases were examined with potassium hydroxide: eight (25%) showed hyphae, and 24 (75%) did not. Skin biopsy specimens from 21 patients showed variable degrees of hyperkeratosis, acanthosis and papillomatosis. Minocycline was prescribed for 22 patients, of whom 14 of 18 (78%) had complete clearing of the skin eruption and four (22%) a partial response. The skin eruptions recurred after stopping treatment in six patients. CONCLUSIONS: CRP occurs predominantly in young adults and teenagers, with cosmetically displeasing brown scaling patches and plaques affecting the neck, upper trunk and axillae. Frequently, the diagnosis is delayed and the disorder not recognized by physicians, including dermatologists. Clinically, the eruption is most often confused with tinea versicolor. Potassium hydroxide staining of the scale is negative in the majority of cases, implying that fungi are not involved in the pathogenesis of this condition, as has been previously proposed. It is important to recognize this disorder, because minocycline therapy is highly effective in most patients. Criteria for the diagnosis are proposed.
M D P Davis; R H Weenig; M J Camilleri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  154     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-25     Completed Date:  2006-06-08     Revised Date:  2007-06-26    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  287-93     Citation Subset:  IM    
Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Antifungal Agents / therapeutic use
Diagnosis, Differential
Hydroxides / diagnostic use
Minocycline / therapeutic use*
Papilloma / drug therapy*,  microbiology,  pathology
Potassium Compounds / diagnostic use
Retrospective Studies
Skin Neoplasms / drug therapy*,  microbiology,  pathology
Treatment Failure
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antifungal Agents; 0/Hydroxides; 0/Potassium Compounds; 10118-90-8/Minocycline; 1310-58-3/potassium hydroxide
Comment In:
Br J Dermatol. 2007 Mar;156(3):583-4   [PMID:  17300258 ]

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