How do you rid of poikiloderma ?

 What is Poikiloderma ?

Poikiloderma of Civatte is a benign , common and chronic condition , which belongs  to the groups of melanodermas . The term poikiloderma refers to a skin change with atrophy where  hypopigmentation /hyperpigmentation changes and dilation of the fine blood vessels can be seen in the affected skin . 

Poikiloderma of Civatte is most common among middle aged and elderly fair skinned individuals , especially among postmenopausal women . The incidence is unknown since many patients have a mild form of the disease and may not seek medical advice .

Pictures of Poikiloderma :





What are the features and causes of Poikiloderma ?

The exactly cause is unkown ,  long term sun exposure is considered to be a main contributing factor . other factors are :

1. Fair skin 

2. Photosensiting components of cosmetics and toiletries , especially perfumes 

3. hormonal changes related to menopause or low oestrogen levels 

4. a genetic predisposition 

Poikiloderma of  Civatte is characterised by confluent reddish - brown patches with atrophy that symmetrically involve sun exposed areas such as the sides of the neck and lateral aspect of the cheeks . Poikiloderma of Civatte usually spares the shaded area under the chin . 

Poikiloderma of Civatte is usually asymptomatic but some patients can feel mild burning , itching , episode flushing and sensitive skin in the affected area . No systemic involvement or severe complication are associated with poikiloderma of civatte . The diagonsis  of poikiloderma of civatte is made  clinically .a punch biopsy can  show typical  histology with hyperkeratosis , epidermal atrophy , pigmentary incntinence , telangiectasia , a variable  superficial dermal lymphohistiocytic infiltrate , and solar elastosis . 

What is the treatment for poikiloderma of civatte ? 

Medical treatment for this condition remains challenging . The patients should be educate about avoiding sun exposure and the correct use of sunscreen . The results of the treatments may be disappointing . 

sun protection including daily spectrum SPF 50 +sunscreen 

avoid all perfumes on or near the affected area, including those in soap 

hydroquinone containing preparation s may help fade the pigmentation 

Hydrocortisone cream applied twice daily for 2-3 months 

topical retinoids could be beneficial if used for about a year .

alpha hydroxy acids can reduce brown pigmentation . 

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