Alsulami Manal, Alharbi Bader, Alotaibi Yaser, Alghamdi Fadi, Alsantali Adel
College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Dermatology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Case Rep Dermatol Med. 2023 Mar 6;2023:9467084. doi: 10.1155/2023/9467084. eCollection 2023.
Confluent and reticulated papillomatosis (CARP) is a rare dermatosis that typically develops in adolescents and young adults. Clinical characteristics include hyperkeratotic papules that coalesce centrally with a reticulated pattern peripherally on the central and upper trunk, neck, and axilla. Its etiology is not precisely known, and disordered keratinization has been postulated as one of the etiologies. Treatment options of the disease include systemic (such as antibiotics, antifungals, and retinoids) and topical treatments (such as lactic acid, antifungals, retinoids, salicylic acid, urea, tacrolimus, and vitamin D analogs). We report a case of a 17-year-old boy, otherwise healthy, presented with a new onset of asymptomatic, persistent, and slowly progressing brownish skin lesions over the trunk for 6 months. The diagnosis was revised to CARP based on clinical and histopathological examination. Treatment with topical tretinoin 0.025% cream once daily was begun. There was complete resolution of his lesions at the end of 8 weeks of therapy. There has been no relapse at 2 months follow-up. The effectiveness of tretinoin in this patient supports the theory that CARP is a keratinization disorder. Initiating treatment with topical tretinoin when no limitations for its use would be reasonable as it can provide a safer alternative to systemic therapy.
融合性网状乳头瘤病（CARP）是一种罕见的皮肤病，通常发生于青少年和年轻成年人。临床特征包括角化过度性丘疹，这些丘疹在中央融合，在躯干中部、上部、颈部和腋窝周围呈网状分布。其病因尚不完全清楚，角化异常被认为是病因之一。该疾病的治疗选择包括全身治疗（如抗生素、抗真菌药和维甲酸类药物）和局部治疗（如乳酸、抗真菌药、维甲酸类药物、水杨酸、尿素、他克莫司和维生素D类似物）。我们报告一例17岁男孩，身体健康，躯干出现新的无症状、持续且缓慢进展的褐色皮肤病变6个月。根据临床和组织病理学检查，诊断修订为CARP。开始每天一次外用0.025%维甲酸乳膏治疗。治疗8周结束时，其病变完全消退。随访2个月无复发。维甲酸在该患者中的有效性支持了CARP是一种角化异常疾病的理论。在没有使用限制的情况下，开始外用维甲酸治疗是合理的，因为它可以提供一种比全身治疗更安全的选择。
