Confluent and Reticulated Papillomatosis With Linear Pseudo-striae: A Description of 20 Cases

Confluent and reticulated papillomatosis, also known as Gougerot-Carteaud Syndrome, is a rare chronic disease typically affecting young adults. Of unknown etiology, the condition is characterised by oval grayish-brown or erythematous papules that coalesce to form a reticular pattern, usually on the trunk, especially in the intermammary or interscapular region and on the neck. Diagnosis is primarily clinical, based on the appearance of the lesions, the areas affected, and the response to treatment with minocycline. We report 20 cases of patients with histologically confirmed confluent and reticulated papillomatosis who presented linear pseudo-striae, a little known diagnostic sign.

Skin disorders in overweight and obese patients and their relationship with insulin

INTRODUCTION

The prevalence of obesity has increased worldwide in recent years. Some authors have described skin conditions associated with obesity, but there is little evidence on the association between insulin levels and such disorders.

OBJECTIVE

To describe the skin disorders present in overweight and obese patients and analyze their association with insulin levels.

MATERIAL AND METHODS

The study included nondiabetic male and female patients over 6 years of age who were seen at our hospital between January and April 2011. All the patients were evaluated by a dermatologist, who performed a physical examination, including anthropometry, and reviewed their medical history and medication record; fasting blood glucose and insulin were also measured. The patients were grouped according to degree of overweight or obesity and the data were compared using analysis of variance or the χ(2) test depending on the type of variable. The independence of the associations was assessed using regression analysis.

RESULTS

In total, 109 patients (95 adults and 13 children, 83.5% female) were studied. The mean (SD) age was 38 (14) years and the mean body mass index was 39.6±8 kg/m(2). The skin conditions observed were acanthosis nigricans (AN) (in 97% of patients), skin tags (77%), keratosis pilaris (42%), and plantar hyperkeratosis (38%). Statistically significant associations were found between degree of obesity and AN (P=.003), skin tags (P=.001), and plantar hyperkeratosis. Number of skin tags, AN neck severity score, and AN distribution were significantly and independently associated with insulin levels.

CONCLUSIONS

AN and skin tags should be considered clinical markers of hyperinsulinemia in nondiabetic, obese patients.

[Acral acanthosis nigricans associated with taking growth hormone]

Acanthosis nigricans is a skin lesion characterized by the presence of a hyperpigmented, velvety cutaneous thickening that usually appears in flexural areas. Less frequently, it can occur in other locations, such as the dorsum of hands and feet. In this case it is called acral acanthosis nigricans. It is a dermatological manifestation of systemic disease. It is often associated with insulin resistance-mediated endocrine diseases. A case is presented on a patient with acanthosis nigricans secondary to the use of growth hormone.