Confluent and reticulate papillomatosis (syn. Gougerot-Carteaud syndrome)

Confluent and reticulated papillomatosis is a rare condition, usually affecting teenagers and young adults, characterised by grey-brown scales on the upper trunk that become confluent.

This chapter is set out as follows:

• Although the cause in unknown there is evidence to suggest an infective aetiology 

• The condition is most commonly seen around puberty
• Patients are usually asymptomatic 

Distribution

• ​Lesions usually arise on the central chest and the midline of the back, and then gradually spread to affect other areas of the trunk, as well as the neck and axillae
• Other sites are occasionally affected 

Morphology

• Lesions are small, grey-brown, and scaly, and over time coalesce to form larger patches with a net-like pattern at the peripheries

• First-line treatment - lymecycline 408 mg OD (or doxycycline 100 mg OD) for 6-8 weeks

• Several other antibiotics, especially minocycline and azithromycin, have also been found to be effective - minocycline has occasionally been associated with hyperpigmentation, hepatotoxicty, and lupus; and should be avoided if possible

• Discontinuation of treatment may result in recurrence