Dermoscopy of poikiloderma of Civatte

Abstract

Summary Introduction: Poikiloderma of Civatte (PC) is a rather common, acquired, chronic dermatosis, most often affecting fair-skinned individuals, especially menopausal females. It is characterized by a combination of linear telangiectasia, mottled hyperpigmentation, and superficial atrophy in a reticular pattern. It is typically located on the V, the sides of the neck, and the peripheral face, invariably sparing the anatomically shaded areas. It runs a chronic, slowly progressive, but indolent course, producing only cosmetic disfigurement. Genetic predisposition; chronic cumulative sun exposure; hormonal changes of menopause (including iatrogenic menopause); and contact sensitization to perfumes and cosmetics, have all been incriminated in its obscure pathogenesis. Material and Methods: Twenty-eight consecutive patients, clinically diagnosed with PC, were included in the study. All patients were evaluated by detailed history, clinical examination, and dermoscopic examination with hand-held dermatoscope and video-dermatoscope. Dermoscopic findings i.e. global patterns, local and additional features, have been recorded and analyzed. Results: In total, 28 patients with PC were recruited. The median age was 55 years (range 26-73 years). There were 19 females (67.86%) aged 46-73 years (median 54 years), and 9 males aged 26-65 years (median 59 years). Six patients (21.43%) had erythemato-telangiectatic PC, two (7.14%) had the pigmented type, and twenty (71.43%) had the mixed type. On dermoscopic examination, the red-white polka dot pattern was observed in 10 cases (35.71%); the fishnet-like pattern in 15 cases (53.57%); the non-specific pattern in 9 cases (32.14%); the spaghetti and meatballs-like pattern in 4 cases (14.28%). In most cases (78.57%), the coexistence of more than one pattern at different sites was noted. As far as local dermoscopic features are concerned, we observed flying seagull-like vessels in 18 cases (64.29%); rhomboidal/polygonal vessels in 15 cases (53.57%); linear irregular vessels in 17 cases (60.71%); dotted/globular vessels in 10 cases (35.71%); white macules in 23 cases (82.14%); brown macules in 11 cases (39.29%); and whitish follicular plugs in 6 cases (21.42%). On videodermoscopy, we could identify the same local features, i.e. the various types of telangiectatic vessels and pigmented structures. Brown macules, in particular, could be readily recognized much more efficiently than with classic dermoscopy. White macules could be appreciated as the holes of the vascular network or areas of sparing. Conclusions: The dermoscopic picture of PC is highly characteristic and corresponds well to both clinical and histological findings. Although the diagnosis of PC is made on clinical grounds, dermoscopy may assist, in doubtful cases, the differentiation from other clinically important forms of poikiloderma, such as poikiloderma atrophicans et vasculare and poikiloderma associated with collagen-vascular disease, as well as from benign dermatoses of the face and neck. In addition, dermoscopy provides further support to the speculation that PC and erythemato-telangiectatic rosacea, may be related and may represent variants in the same nosological spectrum.

Datum der Bewilligung	2021
Originalsprache	Englisch
Gradverleihende Hochschule	Medizinische Universität Graz
Betreuer/-in	Rainer Hofmann-Wellenhof (Betreuer*in)