What is Poikiloderma of Civatte?
Poikiloderma of Civatte is a benign skin condition that was first described in 1923 by Civatte, a French dermatologist. Also known as sun aging, this is a medical condition that appears as a direct result of the chronic exposure to the sun, affecting primarily the neck and chest area. The erythema present in these areas is often associated with pigmentation of different intensities. This is a condition that affects mainly the female population and its severity depends on several factors, including the duration and intensity of the sun exposure, the skin type of the person and clearly, the capacity to tan.
Symptoms of Poikiloderma of Civatte
These are the most common symptoms of poikiloderma of Civatte:
- The skin on the sides of the neck and the chest present a discoloration of a red or brown color
- The skin lesions are usually asymptomatic
- Patient might however report any of the following three symptoms: mild discomfort accompanied by a burning sensation, itching and hyperesthesia
- The area under the chin is not affected, as it is not directly exposed to the sun
- The hair follicles being more visible and prominent
- The pigmentation of the skin is more obvious and, in some patients, the small blood vessels are dilated and broken (these are also known as capillaries and when they are broken, the condition is known as telangiectasia)
What Causes Poikiloderma of Civatte?
The exact cause that leads to the appearance of poikiloderma has yet to be identified. However, it seems that there is a genetic predisposition and that patients who are diagnosed with congenital disorders present a higher risk of developing the condition. Among the most common genodermatoses associated with poikiloderma, you will find the following: Rothmund-Thomson syndrome, Bloom syndrome and dyskeratosis congenita. Other hereditary causes include: atrophic dermatosis, xeroderma pigmentosum and Kindler syndrome. Connective tissue diseases, such as dermatomyositis and lupus, are also incriminated in the appearance of this medical conditions.
Other possible causes are:
- Fungal infection
- Exposure to extreme temperatures (cold and heat)
- Radiotherapy
- Exposure to photosynthesizing components in cosmetics and other skin care products, including shampoos and soaps
Hormonal factors
Treatment
For the majority of the cases of poikiloderma there is no specific medical treatment to follow. However, people who are diagnosed with this medical condition are advised to avoid prolonged sun exposure and wear sunscreen with SPF 50+. Also, in the situation when the condition appears from exposure to harmful substances in cosmetics, it is recommended to avoid using them and replace them with products containing natural ingredients. Also, it might be a good idea to avoid applying perfume in the affected area or using certain soaps.
There are topical preparations containing hydroquinone that can be used in order to reduce the pigmentation in the affected area. Exfoliants that contain either hydroxy acids or tretinoin are recommended as well in order to improve the general aspects of the skin. For more serious cases, in which the pigmentation of the skin is accompanied by telangiectasia, the treatment will either consist of pulsed dye laser or intense pulsed light, both delivering a good response to the symptoms presented.