What it is?

Poikiloderma is a clinical term describing the features of mild scaling, atrophy, variations in pigmentation and telangiectasia.

It is seen in a variety of diseases, including SLE, dermatomyositis, poikiloderma congenitale, congenital telangiectatic erythema, dyskeratosis congenita, poikiloderma of Civatte, Bloom’s syndrome, Cockayne’s syndrome, large plaque parapsoriasis and certain mitochondrial disorders.

Histologic Features:

  • Hyperkeratosis
  • Epidermal atrophy
  • Basal vacuolar change
  • Melanin incontinence
  • Telangiectasia
  • Upper dermal lymphohistiocytic infiltrate


Koebner Phenomenon – injury or trauma to the skin i.e. operations, Bites, cuts, abrasions etc;


Poikiloderma of Civatte, also known as sun aging, is a condition caused by sun exposure. The skin changes as a result of chronic, long term exposure to the sun as well as normal aging. Chronically exposed children can acquire significant damage by age 15. These affects may also become apparent as early as age 20.Lesions associated with poikiloderma of Civatte are usually asymptomatic, although some patients do report mild burning, itching and increased sensitivity of the affected skin. These chronic reddish-brown discolorations are commonly found on the neck and cheeks.

Although the exact causes of poikiloderma of Civatte are unknown, many contributing factors have been identified. Chronic exposure to ultraviolet light is the primary factor, explaining why sun exposed areas are the most prone to developing these lesions. Photosensitizing chemicals in perfumes and cosmetics have been identified as a possible cause of poikiloderma of Civatte. A genetic predisposition may also exist.

Diagnosis is made on clinical findings and several lab tests. A physician may order a simple blood test to exclude connective tissue disease. A biopsy of the lesion in question may also be ordered.

No specific treatment exists for poikiloderma of Civatte but there are various remedies, such as topical retinoids, hydroquinone, and alpha hydroxyl acids that may help. It is very important to protect the skin from the sun to prevent further damage. Avoid being outside in the direct sunlight from 10am-3pm. If spending extended time outside is unavoidable, wear a wide brimmed hat, long sleeved shirt and long pants. A daily moisturizer with an SPF of 15 or higher is recommended for daily use. SPF clothing, which provides an SPF of 55+, also can help block the sun’s harmful rays.

Recently, Intense pulse light (IPL) systems have been found beneficial in the treatment of poikiloderma of Civatte. IPL is a high intensity light source, different from a laser, which emits polychromatic, noncoherent light. This light source is effective in reducing pigmentation changes.


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