Confluent and Reticulated Papillomatosis Associated with Polycystic Ovarian Syndrome

Abstract

Polycystic ovarian syndrome is an endocrine disorder diagnosed commonly in young women. Various cutaneous manifestations can include acanthosis nigricans, acne, hirsutism, and alopecia. Confluent and reticulated papillomatosis is a rare skin condition that may be associated with polycystic ovarian syndrome. The etiology of confluent and reticulated papillomatosis is not yet well established but multiple theories exist regarding its pathogenesis. We describe a woman with established polycystic ovarian syndrome who presented with confluent and reticulated papillomatosis; her skin condition was successfully treated with azithromycin. The clinical features, differential diagnosis, epidemiology, and proposed etiologies for confluent and reticulated papillomatosis are discussed as well as possible treatment options. Among women with polycystic ovarian syndrome, confluent and reticulated papillomatosis and acanthosis nigricans can occur concurrently. Additionally, it is possible that confluent and reticulated papillomatosis occurs more commonly in this patient population.

Resolution of confluent and reticulated papillomatosis after bariatric surgery

“…Tetracyclines have also been used to treat other inflammatory skin disorders. 3 Interestingly, there is a case report of the use of minocycline in CARP which also resulted in improvement of acanthosis as well. 5 The rapid and complete resolution of CARP in our patient within 3 months of her sleeve gastrectomy supports the association of this dermatosis with obesity with its associated inflammatory state and insulin resistance.…”

“…It has also been described in women with polycystic ovarian syndrome. 3 In the current literature, successful treatment of CARP primarily focuses on antibiotics. Oral minocycline has been used effectively to achieve resolution in CARP with limited recurrence.…”

“…Oral minocycline has been used effectively to achieve resolution in CARP with limited recurrence. [3][4][5] Macrolides, such as azithromycin, clarithromycin or erythromycin, have also been effective with fewer side effects 1,3 although their use is less extensively reported.…”

Papilomatose Reticulada e Confluente de Gougerot- -Carteaud: Melhoria Significativa e Sustentada das Lesões com Minociclina Oral

“…3 Algumas hipóteses procuram explicar a sua etiopatogénese. 4 Uma teoria sugere que a alteração da diferenciação e maturação dos queratinócitos tenha papel central. 5 Esta é sustentada por achados de microscopia eletrónica evidenciando alteração arquitetural das células da camada córnea, além da proliferação de grânulos lamelares nos queratinócitos da granulosa.…”

“…5 Esta é sustentada por achados de microscopia eletrónica evidenciando alteração arquitetural das células da camada córnea, além da proliferação de grânulos lamelares nos queratinócitos da granulosa. Tal hipótese é ainda reforçada pelos achados histopatológicos, além do benefício no uso de retinóides e análogos da vitamina D. 4 Outra teoria especula que os achados se devem a reação anormal da epiderme secundária a microrganismos. 4 Inicialmente acreditava-se que a Malassezia spp.…”