Poikiloderma of Civatte is a benign, chronic condition of the skin of the lateral cheeks and the sides of the neck characterized  by a combination of pigmentary changes (both hypopigmentation and hyperpigmentation) telangiectasia and mild atrophy with sparing of the perifollicular skin

Typically reddish-brown pigmentation with atrophy and telangiectasia is present in irregular, more o less symmetrical patches. The central submental region, shaded by the chin, is usually spared.

It is usually asymptomatic, but occasionally patients report mild burning, itching and hyperesthesia. Generally the discomfort is of solely cosmetic concern  in most patients.

It was first described in 1923 by Achille Civatte, French dermatologist (1877-1956), in postmenopausal women.

Poikiloderma of Civatte is rather common and  occurs most commonly in fair-skinned, middle-aged or elderly women.

In the etiology of poikiloderma of Civatte many factors may be implicated:

• Chronic exposure to ultraviolet light with cumulative actinic damage  (distribution on sun-exposed areas and frequent histopathologic finding of solar elastosis).

• Photosensitizing chemicals in perfumes or cosmetics applied on the neck.

• Hormonal changes related to menopause (most patients are middle-aged or elderly women).

• Genetic predisposition (autosomal dominant inheritance with variable penetrance) expressed as an increased susceptibility of the skin to ultraviolet radiation.

Intense pulsed light (IPL) systems (with a low-risk profile of side effects) and pumped pulsed-dye laser (585 nm and 595 nm) have been found beneficial in the treatment of poikiloderma of Civatte with a better low-risk incidence of adverse effects (hypopigmentation and scarring) for IPL.  But it is most important to educate patient about avoiding sun exposure and the proper use of sunscreens. Prevention is based on avoiding perfumes and cosmetics, sun exposure and using proper photoprotection with sunscreen.