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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 ,


Abstract

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.

Keywords: Confluent and reticulated papillomatosis CARP genodermatosis sindrom Gougerot-Carteaud

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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. https://doi.org/10.15562/ism.v13i3.1561
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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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