Translate this page into:
Reticulate Pigmentation Over the Back
*Corresponding author: Siddhartha Dash, Department of Dermatology, and Venereology, S.C.B. Medical College and Hospital, Cuttack, Odisha, India. siddharth101990@gmail.com
-
Received: ,
Accepted: ,
How to cite this article: Dalai S, Mohanty J, Dash S. Reticulate Pigmentation Over the Back. Indian J Postgrad Dermatol. doi: 10.25259/IJPGD_154_2024
A 34-year-old male presented with asymptomatic brownish flat lesions over back for 6 months. On cutaneous examination, the lesion was greyish-brown, scaly plaque which was confluent at the centre and had a peripheral reticulated pattern [Figure 1a]. General and systemic examination was unremarkable. Dermoscopy (Dermlite DL4, ×10 magnification) revealed flat, light-brown globules in a cobblestone pattern along with fine, white scales [Figure 1b]. Histopathology showed hyperkeratosis, low broad papillomatosis, mild acanthosis, mild increase in melanin pigment and perivascular lymphocytic infiltration in dermis [Figure 1c]. Based on clinico-dermoscopic and histopathological findings, final diagnosis of confluent and reticulated papillomatosis was made. There was complete resolution of lesions after treatment with oral minocycline 100 mg once daily in the next 30 days [Figure 1d]. Clinical and dermoscopic differentials have been discussed in Table 1.[1]
- (a) Greyish-brown, scaly plaque over the back, confluent at the centre and reticulated at the periphery. (b) Dermoscopy with Dermlite DL4 under ×10 magnification revealed fine, whitish scaling and flat, light-brown globules in a cobblestone pattern. (c) hyperkeratosis, low broad papillomatosis, mild acanthosis, mild increase in melanin pigment and perivascular lymphocytic infiltration in dermis (haematoxylin and eosin, ×100). (d) Near complete improvement after treatment.
| Skin disorder | Clinical findings | Dermoscopic findings |
|---|---|---|
| CARP | Asymptomatic, greyish-brown, scaly, flat papules that coalesce into larger patches with a reticulated pattern at the periphery | Brownish areas in a cobblestone or ‘sulci and gyri’ pattern with white scales |
| Pityriasis versicolor | Asymptomatic, perifollicular, greyish-brown, scaly macules and patches | Faint pigment network composed of brownish stripes and fine scales |
| Terra firma-forme dermatosis | Asymptomatic, thickened brown-black papules and plaques | Large, polygonal plate-like brown scales arranged in a mosaic pattern |
| Erythema ab igne (pigmented stage) | Brownish patches arranged in lace-like or fishing net pattern | Homogenous brownish pigmentation with or without linear branching vessels or white scales |
| Dowling-Degos disease | Asymptomatic, reticulate brownish macules over the flexures | Brownish star-like area or irregular brownish projections with a hypopigmented centre over a brownish/reddish brown background |
CARP: Confluent and reticulated papillomatosis
Ethical approval
Institutional Review Board approval is not required.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship
Nil.
References
- Dermatoscopy of Confluent and Reticulated Papillomatosis (Gougerot-Carteaud Syndrome) J Dtsch Dermatol Ges. 2017;15:836-8.
- [CrossRef] [Google Scholar]
