Gottron’s Carcinoid Papillomatosis: Case Report

Abstract

Introduction. Gottron’s papillomatosis is a rare benign type of dermatosis with pseudoepitheliomatous hyperplasia of the epidermis, first described as an independent disease by the German dermatologist H.A. Gottron. Invasive epidermal growth and hyperkeratosis reveal no signs of malignancy. Chronic venous insufficiency and lymphedema can be associated with various secondary skin lesions: the formation of ulcers, hyperkeratosis and skin papillomatosis, as well as infectious complications. Skin papillomatosis may be a manifestation of paraneoplastic syndrome, which requires a careful differential diagnosis. Timely treatment of complications in a patient with concomitant somatic pathology performed by a multidisciplinary team of specialists is necessary to improve the prognosis. Considering the relative rarity of Gottron’s papillomatosis and the lack of awareness among practicing physicians regarding the differential diagnosis of this disease, we present this clinical analysis.Description of a clinical case. Patient L., 42 years old (body mass index — 76.5 kg/m2) with chronic lymphovenous insufficiency, lymphedema, erysipelas of the right lower limb associated with unspecified skin papillomatosis, was urgently hospitalized in a health care institution “City Clinical Hospital No. 3” of Grodno (Republic of Belarus), consulted by a multidisciplinary team of clinicians including a therapist, a cardiologist, a dermatologist, an endocrinologist, an infectious disease specialist, and a surgeon. Taking into account the clinical status of the patient and the retrospective analysis of archival records of previous examinations performed on the patient in the health care institution “Grodno University Clinic”, the type of dermatosis was determined as Gottron’s papillomatosis of both lower extremities. In terms of the clinical diagnosis of the patient, complex therapy was initiated in a hospital setting, which was then continued at the outpatient stage.Conclusion. Adequate long-term treatment of morbid obesity and chronic lymphovenous insufficiency is necessary to prevent serious complications. According to the academic literature, timely diagnosis of such a rare dermatosis as Gottron’s papillomatosis, as well as the prescription of adequate therapy determine the possibility of regression in the early stages of the disease.