Poikiloderma of Civatte, first described in 1923 by a French dermatologist1 is a combination of atrophy, telangiectasias and irregularities in pigmentation. This pigmentary change is usually a brownish red reticulated pigmentation. At one time this disorder was felt to be due to a hormonal abnormality and limited to menopausal and post-menopausal women. It is now understood to be a result of chronic sun damage and affects both men and women with excessive sun exposure. This is often found on the cheeks and lateral neck and may extend well down onto the chest. The submental area is conspicuously spared.
Treatments in the past have been largely ineffective. These have included electrocautery, chemical peels and Argon lasers. The Pulsed dye laser with a 585 nm wavelength, a 5 mm spot size and a 360 msec pulse duration was shown to be effective in one patient2. The limitations were the small spot size and the significant purpura that followed the laser treatment.
Stephen W. Eubanks, M.D.
Dermatology & Laser Center, Denver, Colorado, USA
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