A case of confluent and reticulated papillomatosis responsive to ketoconazole cream.

Abstract

We described here a case of a 43-year-old male who developed confluent and reticulated papillomatosis (CRP). The patient was found to be slightly obese and had no family history of such eruption. Numerous small red-brown erythemas were scattered over a wide area of the back and, in many areas, the erythemas coalesced and formed a reticular pattern. The eruptions appeared 10 days prior to the initial visit to our outpatient clinic. The Parker-KOH preparation of scraped scales revealed numerous round and budding non-clustering cells and no mycelial elements. Histological examination showed subtle papillomatosis and sparse perivascular lymphohistiocytic infiltrations. Periodic acid schiff stain showed a few spores in the stratum corneum. Topical application of 2% ketoconazole cream produced complete resolution of the eruption in 7 days. The course and histological findings of our patient suggest the eruptions were developing CRP lesions. Application of topical antifungal agents appears to be a beneficial initial treatment for early CRP lesions.