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December 1985

Confluent and Reticulate Papillomatosis

Author Affiliations

10 Ritherdon Ave Vepery, Madras 7, India 600 007

Arch Dermatol. 1985;121(12):1483. doi:10.1001/archderm.1985.01660120009002

To the Editor.—  In the May 1985 issue of the Archives, Kellet and Macdonald1 described a 21-year-old woman with classic confluent and reticulate papillomatosis (CRP) of nine years' duration who responded rapidly to 2% miconazole cream applied topically. They had quoted the case report by Bruynzeel-Koomen and de Wit2 of a similarly afflicted patient who responded to treatment with oral etretinate.In 1973, my colleagues and I3 reported three cases of CRP; two of the patients responded to topical selenium sulfide, and one responded to parenteral vitamin A therapy alone. On the basis of this study, we proposed that CRP is an abnormal host response to Malassezia furfur. The two popular views about the pathogenesis of CRP are those of Miescher,4 who proposed a keratinization disorder as the basic defect, and Roberts and Lachapelle,5 who suggested an abnormal host response to Pityrosporon orbiculare. Based on

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