minocycline and Papilloma

Concomitant confluent and reticulated papillomatosis (CRP) and acanthosis nigricans (AN) is rare. We present a case of concomitant CRP and obesity-associated AN in a 12-year-old obese Japanese girl. Curiously, oral minocycline therapy, which has been shown to be effective for CRP, was effective against both CRP and AN. Possible mechanisms by which minocycline could have improved skin lesions of CRP and obesity-associated AN are discussed. In addition, reports of concomitant CRP and obesity-associated AN are reviewed. CRP and obesity-associated AN share common clinicopathological features and some reports have described concomitant CRP and obesity-associated AN. Together with the observation that skin lesions of CRP and obesity-associated AN in the present case responded to oral minocycline therapy, these facts suggest a tight relationship or a common pathogenetic pathway between these pathologies.

Topics: Acanthosis Nigricans; Alkaline Phosphatase; Anti-Bacterial Agents; Biopsy; Blood Glucose; C-Peptide; Child; Female; Humans; Insulin Resistance; Minocycline; Obesity; Papilloma; Rare Diseases; Skin; Skin Neoplasms; Syndrome; Treatment Outcome

Confluent and reticulated papillomatosis (CARP) was first described >60 years ago. It is distinct from acanthosis nigricans. This article presents the results of a review of the literature in MEDLINE through May 2006 using the terms 'confluent and reticulated papillomatosis', 'reticulated and confluent papillomatosis of Gougerot and Carteaud', and 'reticulated papillomatosis'. A recent report has linked the presence of Dietzia spp. (family: Dietziaceae; suborder: Corynebacterineae; order: Actinomycetales) in the skin to CARP. CARP has also been linked to defects in keratinization. Other possible causes of CARP that have been suggested but seem less likely include endocrine abnormalities, Pityrosporum, a reaction to UV light, and a variation of cutaneous amyloidosis. CARP has been reported worldwide and occurs in both sexes, all age groups, and all races. The disorder can initially manifest as hyperkeratotic or verrucous papules that coalesce to form a reticular pattern peripherally and confluent plaques centrally. Although a variety of treatments for CARP exist, oral minocycline 50-100mg twice daily has been the preferred treatment. However, recent reports of the effectiveness of azithromycin 250-500mg three times weekly may make azithromycin the preferred treatment for CARP, since it has a more benign adverse effect profile than minocycline. Other effective antibacterial treatments include fusidic acid 1000mg daily, clarithromycin 500mg daily, erythromycin 1000mg daily, tetracycline 500mg twice daily, and cefdinir 300mg twice daily. If a recent finding that CARP is caused by a bacterial microorganism is replicated, treatment should likely be determined by bacterial sensitivities, antibacterial adverse effect profiles, and cost considerations. Other oral treatments of CARP that are effective but currently disfavored because of the effectiveness of minocycline include isotretinoin, acitretin, and etretinate. There have been mixed reports regarding the effectiveness of topical treatments, which include selenium sulfide, ketoconazole cream, tretinoin, tazarotene, tacalcitol, and calcipotriene (calcipotriol).

Topics: Acanthosis Nigricans; Anti-Bacterial Agents; Antifungal Agents; Diagnosis, Differential; Female; Humans; Male; Minocycline; Papilloma

The present report presents two cases of confluent and reticulate papillomatosis. Case 1 was a 24-year-old man who had suffered from skin eruptions for six months, and Case 2 was a 19-year-old woman who had had this disease for three days. In both patients, reticular dark brown papules, accompanied by mild keratosis and infiltration, spread from the trunk to the neck and upper arm. Direct light microscopy did not detect the presence of any fungi, and histopathological examinations confirmed hyperkeratosis, acanthosis, papillomatosis, and mild small-round-cell infiltration. Thus, these patients were diagnosed as confluent and reticulate papillomatosis. Neither one had diabetes or thyroid dysfunction. In Case 1, cefdinir was effective, and in Case 2, minocycline hydrochloride and ketoconazole were effective. To the best of our knowledge, this was the first documented case of confluent and reticulate papillomatosis responding to cefdinir.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Arm; Cefdinir; Cephalosporins; Female; Humans; Male; Minocycline; Neck; Papilloma; Skin Neoplasms; Thorax

Topics: Anti-Bacterial Agents; Humans; Minocycline; Papilloma; Prurigo; Skin Neoplasms

Confluent and reticulate papillomatosis (CRP) is an idiopathic disorder characterized by persistent patches and plaques that are centrally confluent and peripherally reticulate. Although CRP primarily occurs sporadically, there may be a familial predisposition to the development of CRP. Minocycline has been reported as effective in the treatment of CRP, seemingly due to its antimicrobial and anti-inflammatory activity. We describe a case of familial CRP involving 2 brothers who were successfully treated with minocycline.

Topics: Adolescent; Anti-Bacterial Agents; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Treatment Outcome

Confluent and reticulate papillomatosis (CRP) (also known as Gougerot-Carteaud syndrome) is a rare disorder that usually presents sporadically, with onset typically occurring in young .adulthood. We present 2 cases of CRP with typical clinical manifestations of scaly, dull, brownish, confluent and reticulate macules and patches. On examination using a potassium hydroxide (KOH) preparation and Periodic acid-Schiff (PAS) stain, both patients' lesions were negative for fungal elements; in patient 2, bacteria colonies accumulated in follicular orifices without perifollicular inflammation in the dermis. Both patients responded well to treatment with oral minocycline and topical tazarotene and showed clearance of CRP lesions at 12- and 8-month follow-up, respectively.

Topics: Administration, Cutaneous; Administration, Oral; Adult; Anti-Bacterial Agents; Dermatologic Agents; Female; Follow-Up Studies; Humans; Male; Minocycline; Nicotinic Acids; Papilloma; Skin Neoplasms; Treatment Outcome; Young Adult

Topics: Adult; Anti-Bacterial Agents; Axilla; Diagnosis, Differential; Humans; Ichthyosis; Male; Minocycline; Papilloma; Skin Neoplasms; Syndrome; Torso; Treatment Outcome

Confluent and reticulate papillomatosis (CRP) is a rare disorder that has mostly been described in case reports and limited case series. Studies on this condition from our region are lacking.. To describe the clinical and histopathological findings, as well as response to treatment of all patients diagnosed with CRP at the American University of Beirut Medical Center (AUB-MC) between 1999 and 2009, and to compare our findings with those published in the literature.. Confluent and reticulate papillomatosis was diagnosed in 10 patients (five men, five women). Mean age at diagnosis was 19 years. Duration of lesions ranged from few months to several years. Skin lesions mainly consisted of reticulated, pigmented macules, patches and plaques. The most common area of involvement was the chest in five cases. The rash was asymptomatic in eight patients. Skin biopsy specimens from all patients revealed hyperkeratosis, papillomatosis and variable acanthosis. Whereas follicular plugging was observed in nine cases, anastomosis of the rete ridges was noted in three. Periodic acid Schiff stains highlighted yeast forms in six cases.. The clinical and histopathological features of the CRP patients in our study are generally comparable to those published in the literature, with minor differences. Clinically, one case had an atypical clinical presentation, and microscopically follicular plugging was seen in the majority of cases. Yeast-like spores were seen in six cases further supporting a role of Malassezia furfur in the pathogenesis of CRP.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Biopsy, Needle; Cohort Studies; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Immunohistochemistry; Lebanon; Male; Minocycline; Papilloma; Rare Diseases; Retrospective Studies; Skin Neoplasms; Steroids; Treatment Outcome; Tretinoin

Topics: Administration, Oral; Aneuploidy; Chromosomes, Human, Pair 15; Humans; Hyperpigmentation; Male; Minocycline; Papilloma; Skin; Skin Neoplasms; Skin Pigmentation; Treatment Outcome; Young Adult

Confluent and reticulated papillomatosis (CARP), also known as Gougerot-Carteaud syndrome, is a rare disorder. It usually presents as hyperkeratotic brown papules that coalesce into plaques with a reticulated periphery on the central trunk of young adults. Confluent and reticulated papillomatosis is most often clinically confused with tinea versicolor and usually does not respond to therapy with antifungals. Minocycline is the treatment of choice.. Four cases of CARP with the unusual presentation of hypopigmented lesions masquerading as tinea versicolor in dark-skinned (Fitzpatrick skin types IV-V) patients are presented. All cases exhibited characteristic features of CARP on biopsy results and responded to minocycline of several months' duration. Two of the cases were also treated with adjuvant topical tazarotene.. The hypopigmented variant of CARP in dark-skinned patients makes the clinical differentiation from tinea versicolor extremely challenging. Physicians encountering darkly pigmented individuals with hypopigmented plaques unresponsive to antifungals should have a high clinical suspicion for the hypopigmented variant of CARP.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antifungal Agents; Diagnosis, Differential; Female; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Tinea Versicolor; Treatment Failure; Young Adult

Topics: Adult; Arm; Humans; Male; Minocycline; Papilloma; Skin Neoplasms

Topics: Anti-Bacterial Agents; Drug Resistance; Erythromycin; Forehead; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Young Adult

Topics: Anti-Bacterial Agents; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Thorax; Young Adult

Confluent and reticulate papillomatosis (CRP) (Gougerot-Carteaud syndrome) is a disorder that has been characterized in only small cohorts of patients.. Better to characterize the clinical and pathological findings of the disorder.. We retrospectively reviewed the clinical presentation, response to treatment and histological findings of patients presenting to Mayo Clinic (Rochester, MN, U.S.A.) with CRP.. The disorder was diagnosed in 39 patients between 1972 and 2003. Mean age at onset of the skin eruption was 15 years (range 8-32); 21 patients (54%) were male; most were white; most (33) presented for reasons of cosmesis; and eight described the rash as mildly pruritic. At presentation, the skin eruption had been present for a mean of 3.1 years (range 3 months-20 years) and had been recalcitrant to treatment, including antifungal treatment. Typical objective findings were scaling brown macules and patches and velvety papules and plaques, reticulated and papillomatous at least in part, involving the upper trunk, axillae and neck. The most frequent initial diagnostic impressions were tinea versicolor, acanthosis nigricans and CRP. Scales in 32 cases were examined with potassium hydroxide: eight (25%) showed hyphae, and 24 (75%) did not. Skin biopsy specimens from 21 patients showed variable degrees of hyperkeratosis, acanthosis and papillomatosis. Minocycline was prescribed for 22 patients, of whom 14 of 18 (78%) had complete clearing of the skin eruption and four (22%) a partial response. The skin eruptions recurred after stopping treatment in six patients.. CRP occurs predominantly in young adults and teenagers, with cosmetically displeasing brown scaling patches and plaques affecting the neck, upper trunk and axillae. Frequently, the diagnosis is delayed and the disorder not recognized by physicians, including dermatologists. Clinically, the eruption is most often confused with tinea versicolor. Potassium hydroxide staining of the scale is negative in the majority of cases, implying that fungi are not involved in the pathogenesis of this condition, as has been previously proposed. It is important to recognize this disorder, because minocycline therapy is highly effective in most patients. Criteria for the diagnosis are proposed.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antifungal Agents; Biopsy; Child; Diagnosis, Differential; Female; Humans; Hydroxides; Male; Minocycline; Papilloma; Potassium Compounds; Recurrence; Retrospective Studies; Skin Neoplasms; Treatment Failure; Treatment Outcome

Topics: Adult; Anti-Bacterial Agents; Calcitriol; Dermatologic Agents; Drug Resistance; Female; Humans; Minocycline; Papilloma; Skin Neoplasms

Confluent and reticulated papillomatosis is a rare dermatosis of unknown etiology mostly affecting young males and females most common in adolescence. The eruption consists of confluent, flat, brown papules forming a pigmented reticulated pattern. It occurs primarily in the intermammary and epigastric regions but may spread to the axillae. A 27-year-old patient with typical clinical and histologic features of confluent and reticulated papillomatosis responded well to oral minocycline.

Topics: Adult; Anti-Bacterial Agents; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Treatment Outcome

Topics: Acanthosis Nigricans; Adult; Anti-Bacterial Agents; Back; Biopsy; Diagnosis, Differential; Ear; Female; Forehead; Humans; Minocycline; Neck; Papilloma; Skin; Skin Neoplasms; Syndrome; Treatment Outcome

Topics: Adult; Humans; Male; Minocycline; Papilloma; Skin Neoplasms

Confluent and reticulated papillomatosis is an uncommon dermatosis of unknown etiology which is often difficult to diagnose. Lesions appear on the mid-trunk and affect mostly young females. We report a 15-year-old girl with typical clinical and histologic features of this rare disorder in whom the lesions rapidly improved after minocycline therapy. Topical treatment with isotretinoin and erythromycin was ineffective.

Topics: Administration, Oral; Administration, Topical; Adolescent; Biopsy; Cyproterone Acetate; Diagnosis, Differential; Erythromycin; Female; Humans; Isotretinoin; Minocycline; Papilloma; Recurrence; Skin; Skin Neoplasms

Confluent and reticulated papillomatosis is a papulosquamous disorder that affects young individuals. There are several hypotheses regarding the cause, including genetic keratinization disorder, reaction to pityrosporum, and reaction to UV light. Multiple therapeutic agents have been used with variable success. The histologic findings include papillomatosis, hyperkeratosis, and minimal or no acanthosis. We present a patient with the clinical findings of confluent and reticulated papillomatosis who responded dramatically to minocycline, and in whom histologic examination did not reveal papillomatosis.

Topics: Adult; Female; Humans; Minocycline; Papilloma; Skin Neoplasms

Topics: Adult; Biopsy; Drug Administration Schedule; Humans; Male; Minocycline; Papilloma; Physical Examination; Skin

Topics: Adult; Calcitriol; Diagnostic Errors; Follow-Up Studies; Hand Dermatoses; Humans; Hyperpigmentation; Male; Minocycline; Papilloma; Regional Blood Flow; Skin; Skin Diseases, Vascular; Skin Neoplasms; Treatment Failure

Confluent and reticulated papillomatosis (Gougerot and Carteaud) is a distinctive clinico-pathologic entity of unknown etiology, whose relationship to fungi is still controversial. We report a 15-year-old Japanese male in whom Malassezia yeasts were found on direct microscopic examination. Treatment with oral itraconazole initially resulted in partial improvement but later became ineffective. The rash virtually disappeared with administration of minocycline. These observations indicate that the role of Malassezia yeasts in the pathogenesis of this disease is probably less important than that of microorganisms sensitive to minocycline.

Topics: Adolescent; Anti-Bacterial Agents; Antifungal Agents; Dermatomycoses; Follow-Up Studies; Humans; Itraconazole; Malassezia; Male; Minocycline; Papilloma; Recurrence; Skin Neoplasms

Confluent and reticulated papillomatosis (CRP) of Gougerot and Carteaud is an uncommon disorder of unknown cause for which a variety of treatments have been proposed.. We attempted to evaluate the effectiveness of oral minocycline.. Nine patients with CRP were treated with oral minocycline, 50 mg twice a day, for 6 weeks. The average follow-up period was 11 months. Recurrence rate, side effects, and effectiveness of therapy were assessed.. All patients except two had a 90% to 100% response to therapy. Recurrences were noted in three patients, all of whom responded to re-treatment with minocycline. None of the nine patients had an adverse reaction.. Minocycline, 50 mg twice a day, is safe and effective for CRP.

Topics: Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Female; Follow-Up Studies; Humans; Male; Minocycline; Neoplasm Recurrence, Local; Papilloma; Remission Induction; Skin Neoplasms

Confluent and reticulated papillomatosis (CRP) is a rare dermatosis of unknown aetiology. Recent electron microscopic studies suggest that CRP is a disorder of keratinisation. In our case we could not confirm the previously reported ultrastructural findings. CRP is generally resistant to therapy. We treated a 19-year-old patient with typical CRP with oral minocycline. Within a few weeks the eruption resolved completely. A mild relapse 7 months later responded promptly to a repeated course of minocycline. Twelve months after discontinuation of therapy there is no evidence of recurrence. In CRP minocycline should be preferred to systemic retinoid therapy because of its minor side effects.

Topics: Adult; Anti-Bacterial Agents; Biopsy; Dose-Response Relationship, Drug; Drug Administration Schedule; Humans; Male; Microscopy, Electron; Minocycline; Papilloma; Skin; Skin Neoplasms

We report six cases of confluent and reticulated papillomatosis in which the skin lesions cleared almost completely after treatment with minocycline. Patients with confluent and reticulated papillomatosis often do not respond well to a variety of therapeutic agents. The response of confluent and reticulated papillomatosis to minocycline was first described in 1965. Although the pharmacologic mechanisms of minocycline in confluent and reticulated papillomatosis are unknown, we suggest that it should be considered as a first-choice therapeutic agent because of its marked effectiveness.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Female; Follow-Up Studies; Humans; Hyperpigmentation; Male; Minocycline; Neoplasm Recurrence, Local; Papilloma; Skin Neoplasms; Treatment Outcome

Topics: Adolescent; Adult; Anti-Bacterial Agents; Female; Humans; Male; Minocycline; Papilloma; Retrospective Studies; Skin Neoplasms

Topics: Adult; Etretinate; Female; Humans; Hyperpigmentation; Male; Minocycline; Papilloma; Skin Neoplasms

Confluent and reticulate papillomatosis is a rare disorder producing sharply circumscribed hyperpigmented ichthyosiform scaling lesions in a seborrhoeic distribution. Its exact aetiology is unknown and its response to therapy is poor. This case is unusual in responding to minocycline having failed with the more conventional approaches.

Topics: Adolescent; Female; Humans; Minocycline; Neck; Papilloma; Skin Neoplasms; Thorax

Topics: Adolescent; Female; Humans; Minocycline; Papilloma; Pigmentation Disorders; Skin Neoplasms; Syndrome

Topics: Adolescent; Humans; Male; Minocycline; Papilloma; Skin Neoplasms

Topics: Adolescent; Humans; Male; Minocycline; Papilloma; Skin Neoplasms; Tetracyclines