Περίληψη:
Background Poikiloderma of the face and neck (Civatte) is a rather
common, indolent, chronic dermatosis, most often affecting menopausal
females. Cumulative excessive sun exposure, a phototoxic or a
photoallergic reaction, hormonal changes of menopause and genetic
factors have all been incriminated in its obscure aetiopathogenesis.
Objectives To evaluate the role of contact sensitization and
photosensitivity in the pathogenesis of poikiloderma of Civatte (PC).
Methods Thirty-two patients (24 females and eight males, age range 38-74
years) with PC were patch tested with the European standard series and
the fragrance series, and were photopatch tested with the photoallergens
series. Additionally, photo-testing with a monochromator was performed.
Results Thirteen of 32 patients (40.62%) had one or more positive
reactions to allergens of the standard series. Eight patients (25%) had
positive reactions to fragrance mix and/or Balsam of Peru, which are
included in the standard series, or to allergens of the fragrance
series. Nickel sulphate was the single most common cause of contact
sensitization (18.75%) among our patients. Ninety-seven subjects, who
were patch tested with the standard series for suspected allergic
contact dermatitis of the face and/or neck, served as age, sex and site
controls. Of these, nine (9.27%) had one or more positive reactions to
fragrance compounds. Statistical analysis showed a statistically
significant difference in the frequency of positive reactions to
fragrances between the PC group and the control group (chi(2) value =
3.91, P < 0.05). In contrast, none of the PC patients had a positive
photopatch test for the allergens included in the photoallergens series.
The estimated minimal erythemal dose for the PC group was in all cases
within normal limits for all wavelengths of ultraviolet (UV) radiation
examined.
Conclusions Contact sensitization, mostly to perfume ingredients, may
develop in PC, possibly playing a pathogenetic part, at least in a
subset of patients. Despite negative results of photopatch testing, an
allergic photo-contact reaction cannot be definitely excluded. PC seems
not to be a photosensitivity disorder of the type of chronic actinic
dermatitis. UV radiation-induced dermal connective tissue changes are
the predominant histological feature of PC, leading to telangiectasia
due to loss of vascular support. Reticular pigmentation may result from
a delayed hypersensitivity reaction to perfume and/or cosmetic
ingredients. Patch testing with the standard series and avoidance of
documented allergens may be of value in patients with PC.
Συγγραφείς:
Katoulis, AC
Stavrianeas, NG
Katsarou, A
Antoniou, C and
Georgala, S
Rigopoulos, D
Koumantaki, E
Avgerinou, G and
Katsambas, AD
