Confluent and reticulated papillomatosis (CARP) is an uncommon but harmless skin condition. It causes brown or gray patches that may look slightly bumpy or scaly. It is most often seen in teens and young adults. It is not contagious and not related to poor hygiene.
What does it look like? Brown or gray patches. Can look net-like (reticulated). Usually on the chest, upper back, or neck. Mild scale; usually not itchy.
What causes it? The exact cause is unknown. It is not a fungal infection, even though it can look like one. CARP has been associated with a tendency toward insulin resistance and diabetes in some patients.
How is it treated? CARP usually responds very well to treatment. Minocycline 100 mg twice daily for a limited course, e.g. 2 months, is usually given. This medication often clears the rash completely. Take minocycline with a full glass of water. Avoid lying down for 30 minutes after taking it.
After it clears: Use a benzoyl peroxide wash in the shower a few times per week as this may help prevent recurrence
Lifestyle considerations: Because of its association with insulin resistance: Weight loss, if appropriate, healthy eating, and regular exercise may be helpful and are good for overall health.
Will it come back? It can sometimes return, but it remains benign and treatable.
What not to worry about: It is not dangerous. It does not scar. It is not contagious.
When to call us: If there are side effects from the medication or if the rash does not improve.
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