What is the treatment for confluent and reticulated papillomatosis (CARP)?

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Last updated: March 19, 2025View editorial policy

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From the Research

Confluent and reticulated papillomatosis (CARP) is typically treated with topical tretinoin 0.025% cream once daily, as it has been shown to be effective in achieving complete resolution of lesions in a short period of 8 weeks, as demonstrated in a recent case report 1. The treatment of CARP has been a topic of discussion, with various options available, including oral antibiotics, topical retinoids, and antifungals. However, the most recent and highest quality study suggests that topical tretinoin is a safe and effective alternative to systemic therapy 1. Some of the key points to consider when treating CARP include:

  • The use of topical retinoids, such as tretinoin, which work by normalizing keratinocyte differentiation and reducing hyperpigmentation 1
  • The potential role of bacterial colonization, such as Cutibacterium acnes, in the development of CARP, which may be addressed with oral antibiotics like minocycline 2, 3
  • The importance of considering the patient's individual characteristics, such as skin type and potential allergies, when selecting a treatment option
  • The need for maintenance therapy to prevent recurrence, as CARP can be a chronic condition 1 It is essential to note that the treatment of CARP should prioritize the patient's quality of life, morbidity, and mortality, and that the most recent and highest quality study should guide treatment decisions. In this case, the use of topical tretinoin 0.025% cream once daily is the recommended treatment option, as it has been shown to be effective and safe in achieving complete resolution of lesions in a short period 1.

References

Research

Confluent and reticulated papillomatosis: diagnostic and treatment challenges.

Clinical, cosmetic and investigational dermatology, 2016

Research

Confluent and reticulated papillomatosis : a review of the literature.

American journal of clinical dermatology, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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