Confluent and reticulated papillomatosis in Child
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Synopsis
It is clinically characterized by brown, hyperkeratotic or verrucous, thin papules that usually affect the upper central trunk and axillae. These papules coalesce into reticulated plaques. The lesions are usually asymptomatic but may be pruritic. The disorder typically affects young adults. While responsive to treatment, the disease is usually chronic and marked by exacerbations and remissions.
Diagnostic criteria have been proposed by Davis et al (Ann Dermatol. 2014 Jun;26[3]:409-410) due to frequent misdiagnosis of this condition and include the following: (i) clinical findings include scaly brown macules and patches, with at least some appearing reticulated and papillomatous; (ii) involvement of the upper trunk and neck; (iii) negative fungal staining of the scales; (iv) no response to antifungal treatment; and (v) excellent response to minocycline. A second research group proposed revised criteria to include clinical involvement of the flexural areas and management with antibiotics, rather than minocycline specifically.
Codes
ICD10CM:L83 – Acanthosis nigricans
SNOMEDCT:
89987007 – Confluent AND reticulate papillomatosis
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Differential Diagnosis & Pitfalls
- Acanthosis nigricans
- Tinea versicolor
- Seborrheic dermatitis
- Darier disease
- Pityriasis rubra pilaris
- Seborrheic keratosis
- Dermatopathia pigmentosa reticularis
- Epidermal nevus syndrome (see epidermal nevus)
- Erythema dyschromicum perstans
- Dowling-Degos disease (reticulate pigmented anomaly of the flexures)
- Dyskeratosis congenita
- Incontinentia pigmenti
- Erythrokeratodermia variabilis
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Last Reviewed:04/09/2017
Last Updated:05/31/2017
Last Updated:05/31/2017
Confluent and reticulated papillomatosis in Child