What is Poikiloderma?
Poikiloderma is a benign, chronic condition that falls under the category of pigmented skin disorders. The term ‘poikiloderma’ refers to skin changes involving atrophy, where alterations in hypopigmentation/hyperpigmentation and the dilation of fine blood vessels (telangiectasias) can be observed on the affected skin.
Who is Affected by Poikiloderma?
Poikiloderma is most common among middle-aged and older individuals with fair skin, particularly those with significant sun exposure. It is most frequently observed in postmenopausal women. The incidence rate is unknown, as many patients may have a mild form of the disease and may not seek medical advice.
Causes of Poikiloderma
The exact cause of poikiloderma is unknown. Prolonged sun exposure is considered the main contributing factor. Other factors include:
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- Fair skin (Fitzpatrick skin types I and II)
- Photosensitive components in cosmetics and toiletries, especially perfumes
- Hormonal changes associated with menopause or low estrogen levels
- Genetic predisposition
Clinical Manifestations of Poikiloderma
Poikiloderma is characterized by confluent reddish-brown patches with atrophy, symmetrically affecting sun-exposed areas such as the sides of the neck and the lateral aspect of the face. It is usually asymptomatic, but some patients may experience mild burning, itching, episodic redness, and sensitive skin in the affected area.
Treatment of Poikiloderma
Treatment of poikiloderma remains challenging. Patients should be educated on avoiding sun exposure and the proper use of sunscreen and cosmetic products.
A notable therapeutic response has been observed with the use of the non-ablative Candela Nordlys laser, which targets the vascular, pigmented, and textural components of poikiloderma.
The number of treatments is individualized, typically involving 4-6 sessions in a series, spaced one month apart. Effects are noticeable after the first treatment, with a more even skin tone and reduction in hyperpigmentation and redness.