Poikiloderma of Civatte: clinical case
Poikiloderma of Civatte (Poikilodermia vascularis et pigmentosa Civatte) is a chronic skin condition, which is usually considered as a variety of melanoderma. 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 etiological factor. We present a 54-year old female patient, with facial skin lesions. Confluent, symmetrical reticular dark-brown patches were observed on her face, predominantly on cheeks, preauricular zone, on the forehead, on the front and lateral parts of the neck. Patches showed mottled hyperpigmentation and hypopigmentation with numerous telangiectasias with sites of atrophy. In biopsy specimen epidermal changes in the form of atrophy of the epidermis, hyperkeratosis were revealed. Necrotic keratinocytes, perivascular and focal infiltrates were found in the papillary dermis. Occasional lymphocytes extended into the basal layer. Free pigment was revealed in the epidermis and in the superficial layer of the dermis, multiple melanophages were found in the dermis.