Poikiloderma of Civatte

Poikiloderma of Civatte (Poikilodermia vascularis et pigmentosa Civatte) is a chronic skin condition which refers to the group of melanodermas. Poikiloderma of Civatte (PC) is characterized by erythema associated with atrophy and pigmentation changes of the skin usually seen on the sun exposed areas such as cheeks and sides of the neck. Chronic exposure to ultraviolet light is considered to be an important etiologic factor. We report a 54 years old female patient presenting with confluent, symmetrical reticular dark-brown patches on her face, predominantly on the cheeks, in the preauricular zone, on the forehead and on the front and lateral parts of the neck. Characteristic of the patches are mottled hyper- and hypopigmentation with numerous telangiectasias and areas of atrophy. A biopsy specimen shows epidermal changes including atrophy of the epidermis and hyperkeratosis. Necrotic keratinocytes are found in the papillary dermis as well as occasional lymphocytes extending into the basal layer. The basal damage is associated with dermal involvement. The dermal infiltrate is predominantly lymphocytic. Multiple melanophages, free pigment and edema are seen in the dermis.