Histologic Findings

The epidermis shows moderate thinning of the stratum malpighii, hydropic degeneration of the basal cells, and effacement of the rete ridges. In the upper dermis, a bandlike inflammatory infiltrate primarily is composed of lymphocytes with few histiocytes, in addition to pigment incontinence. In late stages, a thin flattened epidermis, edema in the upper dermis, and dilated blood vessels are demonstrated.

Katoulis et al report that poikiloderma of Civatte has distinct histological and ultrastructural features, stating these features are characteristic but not pathognomonic and that poikiloderma of Civatte should be considered a separate entity.^[9]

Treatment & Management

Khunkhet S, Wattanakrai P. The possible role of contact sensitization to fragrances and preservatives in poikiloderma of civatte. Case Rep Dermatol. 2014 Sep. 6 (3):258-63. [QxMD MEDLINE Link].
Goldberg LH, Altman A. Benign skin changes associated with chronic sunlight exposure. Cutis. 1984 Jul. 34(1):33-8, 40. [QxMD MEDLINE Link].
Lautenschlager S, Itin PH. Reticulate, patchy and mottled pigmentation of the neck. Acquired forms. Dermatology. 1998. 197(3):291-6. [QxMD MEDLINE Link].
Navarro-Trivino FJ, Torres-Puchol VG, Ruiz-Villaverde R. PDT and BF-200 ALA: The therapy option for the treatment of Poikiloderma of Civatte. Dermatol Ther. 2018 Jul. 31 (4):e12648. [QxMD MEDLINE Link].
Graham R. What is poikiloderma of Civatte?. Practitioner. 1989 Sep 22. 233(1475):1210. [QxMD MEDLINE Link].
Katoulis A, Makris M, Gregoriou S, Rallis E, Kanelleas A, Stavrianeas N, et al. Poikilodermatous changes on the forearms of a woman practicing aroma-therapy: extracervical poikiloderma of Civatte?. An Bras Dermatol. 2014 Jul. 89(4):655-6. [QxMD MEDLINE Link].
Katoulis AC, Stavrianeas NG, Georgala S, et al. Familial cases of poikiloderma of Civatte: genetic implications in its pathogenesis?. Clin Exp Dermatol. 1999 Sep. 24(5):385-7. [QxMD MEDLINE Link].
Nofal A, Salah E. Acquired poikiloderma: proposed classification and diagnostic approach. J Am Acad Dermatol. 2013 Sep. 69(3):e129-40. [QxMD MEDLINE Link].
Katoulis AC, Stavrianeas NG, Panayiotides JG, et al. Poikiloderma of Civatte: a histopathological and ultrastructural study. Dermatology. 2007. 214(2):177-82. [QxMD MEDLINE Link].
Goldman MP, Weiss RA. Treatment of poikiloderma of Civatte on the neck with an intense pulsed light source. Plast Reconstr Surg. 2001 May. 107(6):1376-81. [QxMD MEDLINE Link].
Raulin C, Greve B, Grema H. IPL technology: a review. Lasers Surg Med. 2003. 32(2):78-87. [QxMD MEDLINE Link].
Weiss RA, Goldman MP, Weiss MA. Treatment of poikiloderma of Civatte with an intense pulsed light source. Dermatol Surg. 2000 Sep. 26(9):823-7; discussion 828. [QxMD MEDLINE Link].
Wheeland RG, Applebaum J. Flashlamp-pumped pulsed dye laser therapy for poikiloderma of Civatte. J Dermatol Surg Oncol. 1990 Jan. 16(1):12-6. [QxMD MEDLINE Link].
Rusciani A, Motta A, Fino P, Menichini G. Treatment of poikiloderma of Civatte using intense pulsed light source: 7 years of experience. Dermatol Surg. 2008 Mar. 34(3):314-9; discussion 319. [QxMD MEDLINE Link].
Campolmi P, Bonan P, Cannarozzo G, Bruscino N, Troiano M, Prignano F, et al. Intense pulsed light in the treatment of non-aesthetic facial and neck vascular lesions: report of 85 cases. J Eur Acad Dermatol Venereol. 2011 Jan. 25(1):68-73. [QxMD MEDLINE Link].
Scattone L, de Avelar Alchorne MM, Michalany N, Miot HA, Higashi VS. Histopathologic changes induced by intense pulsed light in the treatment of poikiloderma of Civatte. Dermatol Surg. 2012 Jul. 38(7 Pt 1):1010-6. [QxMD MEDLINE Link].
Sarac G, Kapicioglu Y, Cenk H. A new treatment option for poikiloderma of Civatte: 577 nm pro-yellow laser. J Cosmet Dermatol. 2022 Jan. 21 (1):316-319. [QxMD MEDLINE Link].
Meijs MM, Blok FA, de Rie MA. Treatment of poikiloderma of Civatte with the pulsed dye laser: a series of patients with severe depigmentation. J Eur Acad Dermatol Venereol. 2006 Nov. 20(10):1248-51. [QxMD MEDLINE Link].
Clark RE, Jimenez-Acosta F. Poikiloderma of Civatte. Resolution after treatment with the pulsed dye laser. N C Med J. 1994 Jun. 55(6):234-5. [QxMD MEDLINE Link].
Geronemus R. Poikiloderma of civatte. Arch Dermatol. 1990 Apr. 126(4):547-8. [QxMD MEDLINE Link].
Haywood RM, Monk BE. Treatment of poikiloderma of Civatte with the pulsed dye laser: a series of seven cases. J Cutan Laser Ther. 1999 Jan. 1(1):45-8. [QxMD MEDLINE Link].
Batta K, Hindson C, Cotterill JA, Foulds IS. Treatment of poikiloderma of Civatte with the potassium titanyl phosphate (KTP) laser. Br J Dermatol. 1999 Jun. 140(6):1191-2. [QxMD MEDLINE Link].
Ross BS, Levine VJ, Ashinoff R. Laser treatment of acquired vascular lesions. Dermatol Clin. 1997 Jul. 15(3):385-96. [QxMD MEDLINE Link].
Bernstein EF, Schomacker K, Paranjape A, Jones CJ. Treatment of poikiloderma of Civatte using a redesigned pulsed dye laser with a 15 mm diameter treatment spot. Lasers Surg Med. 2019 Jan. 51 (1):54-58. [QxMD MEDLINE Link]. [Full Text].
Behroozan DS, Goldberg LH, Glaich AS, Dai T, Friedman PM. Fractional photothermolysis for treatment of poikiloderma of civatte. Dermatol Surg. 2006 Feb. 32(2):298-301. [QxMD MEDLINE Link].
Tierney EP, Hanke CW. Review of the literature: Treatment of dyspigmentation with fractionated resurfacing. Dermatol Surg. 2010 Oct. 36(10):1499-508. [QxMD MEDLINE Link].
Tierney EP, Hanke CW. Treatment of Poikiloderma of Civatte with ablative fractional laser resurfacing: prospective study and review of the literature. J Drugs Dermatol. 2009 Jun. 8 (6):527-34. [QxMD MEDLINE Link].

Media Gallery

Poikiloderma of Civatte over the neck. Notice sparing of the area under the chin. Courtesy of Dr. Shukrallah Zaynoun.

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Author

Jeannette Rachel Jakus, MD, MBA Clinical Assistant Professor, Director of Clinical Research, Assistant Program Director, Department of Dermatology, SUNY Downstate Medical Center; Dermatologist, Brody Dermatology

Jeannette Rachel Jakus, MD, MBA is a member of the following medical societies: American Academy of Dermatology, American Academy of Pediatrics, American Skin Association, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Craig A Elmets, MD Professor and Chair, Department of Dermatology, Director, Chemoprevention Program Director, Comprehensive Cancer Center, UAB Skin Diseases Research Center, University of Alabama at Birmingham School of Medicine

Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: University of Alabama at Birmingham; University of Alabama Health Services Foundation<br/>Serve(d) as a speaker or a member of a speakers bureau for: Ferndale Laboratories<br/>Received research grant from: NIH, Veterans Administration, California Grape Assn<br/>Received consulting fee from Astellas for review panel membership; Received salary from Massachusetts Medical Society for employment; Received salary from UpToDate for employment. for: Astellas.

Nelly Rubeiz, MD Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Professor, Department of Dermatology, American University of Beirut, Lebanon

Nelly Rubeiz, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

Lana H Hawayek, MD Assistant Professor of Dermatology, Cosmetic Dermatologic Surgery and Laser Specialist, University of Cincinnati, Veterans Affairs Medical Center; Consulting Staff, University Dermatology Consultants

Lana H Hawayek, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Poikiloderma of Civatte Workup

Histologic Findings

References

Tables

Contributor Information and Disclosures

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