HPI: The patient was seen on 2 January, 2014 complaining of the gradual development of hyperpigmentation on chest, abdomen and neck. Good general health. He takes no medications by mouth.
O/E: confluent uniformly tan papules and plaques chest, abdomen, axillae and neck. The primary lesions are barely elevated confluent papules and plaques. KOH negative.
Hyperkeratosis and papilloimatosis c/w CARP
Photos courtesy of Lynne Goldberg, Dermatologist. Boston University School of Medicine. Department of Dermatology and Dermatopathology
Diagnosis: Confluent and Reticulated Papillomatosis of Gougerot and Cartaud (CARP)
Course: The patient was placed on minocycline 100 mg b.i.d. and will be seen in followup in one month. At one month, his CARP has resolved completely,
Discussion: CARP is a true "dermatologic vignette." Once it is seen a few times, the diagnosis is clear. Etiology is still a question, but the disorders remarkable improvement with minocycline should give us some clues. Azithromycin appears equally as effective. It also costs less than minocycline and has a more benign side-effect profile.
1. eMedicine CARP