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Kasus dermatosis langka: confluent and reticulated papillomatosis pada seorang anak

  • I Gusti Ayu Agung Dwi Karmila ,
  • Herman Saputra ,
  • Joice Gunawan Putri ,
  • Made Sanitca Indah ,


Background: Confluent and reticulated papillomatosis (CARP) or Gougerot-Carteaud syndrome is a rare and chronic skin disorder characterized by hyperpigmented and cofluent papules/macules/plaques forming a reticular pattern. The characteristics especially occur in adolescents and young adults. Treatment of CARP is difficult and has not yielded good results. This case describes CARP in a young male patient.

Case: A 6-year-old male complained of brownish spots on his face, hands and feet since 5 years ago. It were initially appeared small without itching or pain. Dermatological exmaniation showed hyperpigmented macules, hyperpigmented plaques, confluent to form a reticular pattern. Dermoscopy examination showed a brownish appearance, homogeneous separated by white striae. Histopathological examination revealed acanthosis down growth, reticulated, mild distribution of lymphocytes and perivascular mast cells in the superficial and mild dermis. The patient was diagnosed with CARP and given intraoral azithromycin 250 mg every 24 hours for 2 weeks and ketoconazole 2% shampoo 3 times a week. Follow-up at week 4 there was no significant improvement.

Conslucion: Incident cases of CARP are rare, so there is no alternative therapy for the management of this disease. In this case, new lesions were found after administration of therapy and the prognosis for the patient was poor.


Latar belakang: Confluent and reticulated papillomatosis (CARP) atau sindrom Gougerot-Carteaud merupakan suatu kelainan kulit langka dan kronis dengan karakteristik papul/makula/plak hiperpigmentasi konfluen membentuk pola retikuler. Kelainan ini terutama pada remaja dan dewasa muda. Terapi CARP sulit dan belum memberikan hasil yang baik. Kasus ini mendeskripsikan CARP pada seorang anak laki-laki.

Kasus: Seorang anak laki-laki 6 tahun dengan keluhan bercak kecoklatan pada wajah, tangan dan kaki sejak 5 tahun lalu, awalnya muncul kecil, tanpa disertai gatal maupun nyeri. Status dermatologi didapatkan makula hiperpigmentasi, plak hiperpigmentasi, berkonfluens membentuk pola retikuler. Pemeriksaan dermoskopi didapatkan gambaran kecoklatan, homogen dipisahkan oleh striae putih. Pemeriksaan histopatologi didapatkan gambaran acanthosis down growth, reticulated, sebaran ringan limfosit dan sel mast perivascular pada superfisial dan mild dermis. Pasien didiagnosis CARP dan diberi terapi  Azitromisin 250 mg tiap 24 jam  intraoral selama 2 minggu dan ketokonazol 2% sampo 3 kali seminggu. Follow-up minggu ke-4 tidak terdapat perbaikan signifikan.

Simpulan: Insiden kasus CARP jarang ditemukan sehingga belum terdapat terapi pilihan untuk tatalaksana penyakit ini. Pada kasus ini masih ditemukan muncul lesi baru setelah pemberian terapi dan prognosis pada pasien adalah dubia ad malam.


  1. Paller A, Mancini A. Confluent and reticulated papillomatosis. In: Clinical Pediatric Dermatology, 4th Edition. Canada: Elsevier; 2011. p. 555–6.
  2. Morales-Cardona C, Tejada-Figueroa C, Méndez-Velasco D. Confluent and Reticulated Papillomatosis With Linear Pseudo-striae: A Description of 20 Cases. Actas Dermosifiliogr (Engl Ed). 2018;102(2):e7–11.
  3. Chang M. Disorders of Hyperpigmentation. In: Bolognia J, Jorizzo J, Rapini R, editors. Dermatology 2nd Edition. Philadelphia: Mosby; 2008. p. 1115–38.
  4. Lalas A, Errchetti E, Ioannides D. Dermoscopy in General Dermatology 1st Edition. Florida: CRC Press; 2019. 106–12 p.
  5. Johnston R. Miscellaneous Conditions. In: Weedon’s Skin Pathology Essentials 2nd Edition. China: Elsevier; 2017. p. 386–7.
  6. Lee S, Loo C, Tan W. Confluent and reticulated papillomatosis: Case series of 3 patients from Kedah, Malaysia and literature review. Med J Malaysia. 2018;73(5):338–9.
  7. Atas H, Keseroglu H, Gonul M, Khurami F. Successful treatment of confluent and reticulated papillomatosis with tetracycline and mupirocin. Turkderm-Turk Arch Dermatol Venereol. 2018;52(64–6).
  8. Lim J, Tey H, Chong W. Confluent and reticulated papillomatosis: diagnostic and treatment challenges. Clin Cosmet Investig Dermatol. 2016;9:217–23.
  9. Errichetti E, Stinco G. Dermoscopy in General Dermatology: A Practical Overview. Vol. 6, Dermatology and Therapy. Springer Healthcare; 2016. 471–507 p.
  10. Le C, Bedocs P. Confluent And Reticulated Papillomatosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited September, 23rd 2022]. p. 1–22. Available from:
  11. Chu A, Teixeira F. Acquired Disorders of Epidermal Keratinization. In: Griffiths C, Barker J, Bleiker T, Chalmer R, Creamer D, editors. Rook’s Textbook of Dermatology, 9 Edition. United Kingdom: Willey Blackwell; 2016. p. 87.5-87.7.
  12. Natarajan S, Milne D, Jones A, Goodfellow M, Perry J, Koerner R. Dietzia strain X: a newly described Actinomycete isolated from confluent and reticulated papillomatosis. Br J Dermatol. 2005;153(4):825–7.
  13. Ahronowitz I, Leslie K. Yeast Infection: Malassezia. In: Kang S, Amagi M, Bruckner A, Enk A, Margolis D, McMichael A, et al., editors. Fitzpatrick’s Dermatology in General Medicine, 9th ed. New York: Mc Graw Hill; 2019. p. 2952–64.
  14. Berg M-HH, Pehr K. Familial Confluent and Reticulated Papillomatosis in 2 Kindreds Including 3 Generations. J Cutan Med Surg. 2018;22(3):330–2.
  15. McMullan B, Mostaghim M. Prescribing azithromycin. Aust Prescr. 2015;38(3):87–9.
  16. Ghannoum M, Salem I, Christensen L. Antifungals. In: Kang S, Amagi M, Bruckner A, Enk A, Margolis D, McMichael A, et al., editors. Fitzpatrick’s Dermatology 9th Edition. New York: Mc Graw Hill Education; 2019. p. 3438–50.
  17. Jimbow M, Talpash O, Jimbow K. Confluent and reticulated papillomatosis: clinical, light and electron microscopic studies. Int J Dermatol. 1992;31:480–3.
  18. Fite LP, Cohen PR. Polycystic Ovarian Syndrome-associated Confluent and Reticulated Papillomatosis: Report of a Patient Successfully Treated with Azithromycin. J Clin Aesthet Dermatol. 2017;10(9):30–5.

How to Cite

Karmila, I. G. A. A. D., Saputra, H., Putri, J. G., & Indah, M. S. . (2022). Kasus dermatosis langka: confluent and reticulated papillomatosis pada seorang anak. Intisari Sains Medis, 13(3), 747–752.




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I Gusti Ayu Agung Dwi Karmila
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Herman Saputra
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Joice Gunawan Putri
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Made Sanitca Indah
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