Confluent And Reticulate Papillomatosis

A 17 year old South Indian female born of consanguineous marriage presented with a widespread non-itchy eruption over scalp, face, below breasts and flexural aspects of limbs including axillae, inguinal regions and popliteal fossae since 3 months of age. The eruption consisted of individual small, flat, brownish black hyperkeratotic papules, which at some places, coalesced to from a reticulate pattern. Histopathological examination of biopsies from the axilla and forearm showed typical hyperkeratosis and papillomatosis without acanthosis. The dermis demonstrated a mild perivascular infiltrate. On the basis of the clinical and histopathological findings, a diagnosis of confluent and reticulate papillomatosis of Gourgerot and Carteaud was made. Partial response to doxycline in our case point towards this being a keratinization disorder where microflora may be playing an exacerbating rather than a primary role.