Response of confluent and reticulate papillomatosis of Gougerot and Carteaud to topical tretinoin.

Confluent and reticulate papillomatosis (CRP) of Gougerot and Carteaud is a rare cutaneous disorder characterized by persistent, usually asymptomatic, dark papules and plaques centrally located on the back, intermammary, and epigastric areas. The eruption spreads out peripherally into a fading reticulated pattern. The pathogenesis is poorly understood, but there are several theories. Many different treatments, with varying success rates, have been attempted. We present 3 patients with CRP who had excellent results in the areas treated with topical tretinoin. The only difficulty with therapy is applying the tretinoin to the back, which sometimes necessitates a second person. However, if this situation can be overcome, topical tretinoin provides an effective, safe alternative to systemic therapies. Response to tretinoin provides support that CRP is a disorder of keratinization. Finally, the fact that 2 of the patients were brothers may support the idea that CRP has a hereditary influence.