Shashikumar B M, Harish M R, Deepadarshan K, Kavya M, Mukund P, Kirti P
Department of Dermatology, Mandya Institute of Medical Sciences, Mandya, Karnataka, India.
Department of Dermatology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Indian Dermatol Online J. 2021 Jan 16;12(1):90-96. doi: 10.4103/idoj.IDOJ_288_20. eCollection 2021 Jan-Feb.
Confluent and reticulate papillomatosis (CRP) is an uncommon benign, acquired keratinization disorder. Studies on this disorder are lacking except for a few case reports and there is a paucity of Indian literature on the condition.
OBJECTIVES/METHODS: To study and describe the various morphological patterns and histopathological findings, as well as assess the response to treatment of 30 patients diagnosed with CRP.
Thirtypatients with a diagnosis of confluent and reticulate papillomatosis were included in the study. The male to female ratio was 1:1.5. Mean age at onset of skin eruptions was 27.3 years and mean duration of skin eruptions was 8.2 months. Most of the patients (60%) were asymptomatic. The majority (66.7%) had lesions distributed over upper trunk. Two-thirds of patients had typical brown macules in confluent and reticulate pattern. KOH mount was done in 24 cases and was positive in three cases (12.5%) for yeast-like hyphae. Biopsy demonstrated variable degrees of hyperkeratosis, papillomatosis, and moderate acanthosis. Thirteen out of eighteenpatients on minocycline showed complete clearance within 3 weeks andthreepatients had more than 50% improvement at the end of 3 weeks. Doxycycline showed satisfactory response but results were less satisfactory with azithromycin.
CRP is an uncommon condition. There is a paucity of large studies in Indian literature. The present study highlightssuch a large cohort of cases. Prevalence of CRP was more in female in contrast to western studies. Association of CRP with hyperthyroidism was described in many studies but the present study highlights the association with hypothyroidism. Morphological variants like shiny atrophic lesions, verrucous lesions, and involvement of atypical sites like forearm have been described. Role of minocycline in the management of chronic and recurrent cases has been reinforced.
融合性网状乳头瘤病（CRP）是一种罕见的良性获得性角化异常疾病。除了少数病例报告外，对该疾病的研究较少，且印度关于此病的文献也很匮乏。
目的/方法：研究并描述30例诊断为CRP患者的各种形态学模式和组织病理学表现，并评估其对治疗的反应。
本研究纳入了30例诊断为融合性网状乳头瘤病的患者。男女比例为1:1.5。皮疹发作的平均年龄为27.3岁，皮疹的平均持续时间为8.2个月。大多数患者（60%）无症状。大多数（66.7%）患者的皮损分布于上胸部。三分之二的患者有典型的融合性和网状褐色斑疹。对24例患者进行了氢氧化钾涂片检查，其中3例（12.5%）发现酵母样菌丝阳性。活检显示不同程度的角化过度、乳头瘤样增生和中度棘层肥厚。18例服用米诺环素的患者中有13例在3周内完全清除，3例患者在3周结束时改善超过50%。多西环素显示出满意的反应，但阿奇霉素的效果不太理想。
CRP是一种罕见的疾病。印度文献中缺乏大型研究。本研究突出了如此大量的病例。与西方研究相比，CRP在女性中的患病率更高。许多研究描述了CRP与甲状腺功能亢进的关联，但本研究突出了其与甲状腺功能减退的关联。还描述了如光泽萎缩性皮损、疣状皮损等形态学变异以及前臂等非典型部位受累的情况。强化了米诺环素在慢性和复发性病例管理中的作用。
