Krishnamoorthy Meera, Nadler Evan, Vaidya Susma
School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
Children's National Obesity Programs, Adolescent Weight-loss Surgery Program, Children's National Health System, Washington, District of Columbia, USA.
Clin Obes. 2021 Feb;11(1):e12427. doi: 10.1111/cob.12427. Epub 2020 Nov 8.
Confluent and reticulated papillomatosis (CARP), a rare dermatologic disorder characterized by hyperpigmented papules that subsequently develop into plaques with reticulated margins, is frequently confused with acanthosis nigricans. The aetiology and pathogenesis of CARP is not yet fully understood, but it is often present in individuals with obesity and PCOS. This case report describes an African American adolescent female with obesity with a rash diagnosed as CARP after unsuccessful treatment with antifungals and corticosteroids. Her dermatosis proved recalcitrant to antibiotics and metformin but started to resolve immediately after bariatric surgery. This case report supports insulin resistance as a contributor to CARP's pathogenesis and as well as its association with obesity. Clinically significant weight reduction should be considered in the management of this challenging skin condition.
融合性网状乳头瘤病（CARP）是一种罕见的皮肤病，其特征为色素沉着丘疹，随后发展为边缘呈网状的斑块，常与黑棘皮病相混淆。CARP的病因和发病机制尚未完全明确，但常出现在肥胖和多囊卵巢综合征患者中。本病例报告描述了一名肥胖的非裔美国青少年女性，其皮疹在抗真菌药和皮质类固醇治疗无效后被诊断为CARP。她的皮肤病对抗生素和二甲双胍治疗无效，但在减肥手术后立即开始好转。本病例报告支持胰岛素抵抗是CARP发病机制的一个因素，以及它与肥胖的关联。在这种具有挑战性的皮肤疾病的管理中，应考虑临床上显著的体重减轻。
