Topical Tretinoin Treatment for Confluent and Reticulated Papillomatosis

Noh, Tae Woo; Kang, Yoo Seok; Lee, Un Ha; Park, Hyun Su

Abstract

BACKGROUND
Confluent and reticulated papillomatosis (CRP) is a rare cutaneous disorder, characterized by persistent, scaling brown papules, patches, and plaques located on the trunk, neck, axillae, and shoulders. Many different treatments with variable success have been attempted, and oral minocycline treatment is effective in most patients with CRP. There were a few case reports of CRP responding to topical retinoid, but no clinical studies on the efficacy of the topical retinoid treatment for CRP have been reported.
OBJECTIVE
The purpose of this study was to evaluate the efficacy and safety of the topical tretinoin treatment for CRP.
METHODS
A retrospective study was performed based on the medical records and clinical photographs of patients with CRP treated with 0.025% tretinoin cream.
RESULTS
Nine patients (4 men and 5 women) were enrolled in the study. The mean age of the patients was 17.4 (11~34) years and the mean age at onset of CRP was 15.1 (3~33) years. The duration of disease varied from 1 month to 7 years. Six of the nine patients showed complete remission, and CRP lesions improved markedly after averagely 6.2 weeks from the beginning of the topical tretinoin treatment. The treatment response was better in patients without itch than in patients with itch (p=0.048). Adverse effects were detected in 3 patients, and were mild irritant contact dermatitis to the topical tretinoin.
CONCLUSION
We think that topical 0.025% tretinoin treatment is an effective and safe treatment modality for CRP and this treatment can be an alternative or additional modality to the systemic treatment.