Background
Poikiloderma of Civatte is an acquired poikiloderma of the lateral face and neck first described by the French dermatologist Achille Civatte in 1923.
Pathophysiology
Poikiloderma of Civatte is a commonly acquired chronic and progressive condition affecting mostly older fair-skinned individuals, and, although benign, it may result in significant cosmetic disfigurement. While the exact pathogenesis of this condition is still unknown, several causative factors have been hypothesized, including long-term ultraviolet (UV) exposure, hormonal changes of menopause, genetics, and contact hypersensitivity, most specifically to fragrances and cosmetics. [1]
Epidemiology
Frequency
The incidence of poikiloderma of Civatte is unknown; many patients may have a mild form of the disease and may not seek medical attention.
Race
Poikiloderma of Civatte occurs most commonly in fair-skinned individuals.
Sex
Poikiloderma of Civatte occurs more commonly in females than in males. [2]
Age
Most commonly, individuals affected are middle-aged or elderly women; however, the disease has been seen in other age groups.
Prognosis
Poikiloderma of Civatte is a chronic and progressive skin condition and, although benign, may result in cosmetic disfigurement that can be quite concerning to some patients. Patients with the mild form typically do not seek medical advice.
Patient Education
Patients should be instructed to minimize UV exposure and to apply a broadband sunscreen of SPF 30 or more every day to all exposed areas of the face and neck. It is important to also remind patients to reapply their sunscreen every 1.5-2 hours or sooner if after exercise or water exposure.
Patients should also be instructed to avoid the application of fragrances or cosmetics to the affected areas.
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Poikiloderma of Civatte over the neck. Notice sparing of the area under the chin. Courtesy of Dr. Shukrallah Zaynoun.
