Περίληψη:
Background: Poikiloderma of the face and neck (Civatte) has not been
studied in depth for decades, especially as far as the histopathology is
concerned. Material and Methods: We studied 50 consecutive patients with
poikiloderma of Civatte (PC). Their evaluation included: history,
physical examination, lesional skin biopsy and histological examination
of sections stained with hematoxylin-eosin, PAS, Fontana-Masson, acid
orcein Giemsa for elastic fibers and toluidine blue for mast cells. In
10 randomly selected subjects, a second skin biopsy was performed and
specimens were examined under the electron microscope. Results: There
were 34 females (68%) and 16 males. The mean age at diagnosis was 47.8
years for females and 61.7 years for males. Histological examination
revealed an atrophic (62%), flattened (84%) epidermis with
hyperkeratosis (92%) and occasional follicular plugging (34%). In some
cases, mild hydropic degeneration of the basal cell layer was evident
(46%). Melanin was irregularly distributed in the lower epidermis (
94%), and melanophages were often present in the dermis (92%). The
most prominent and constant feature (100%) was solar elastosis of the
papillary dermis. The blood vessels were almost invariably dilated
(96%) with a mild perivascular lymphohistiocytic infiltrate (78%),
sometimes with plasmacytes (56%). At the ultrastructural level, the
epidermis showed only minor changes. The dermoepidermal junction was
intact. The most constant findings were swelling and disruption of the
collagen fibers as well as focal degeneration of the collagen bundles.
Occasionally, several vacuolar spaces were found just under the basal
lamina. Melanin-laden macrophages scattered in the dermis were also
detected. Conclusions: PC shows distinct histological and
ultrustructural features, supporting the theory that it represents a
separate entity. The histology of PC is characteristic but not
pathognomonic. On this basis, the differential diagnosis from Riehl’s
melanosis, poikiloderma atrophicans et vasculare and other acquired
poikilodermas can be made. Ultrastructural findings were consistent with
the histological findings. Changes of the dermal connective tissue (
solar elastosis) predominated, providing morphological evidence for the
role of ultraviolet radiation in the pathogenesis of PC. Copyright (c)
2007 S. Karger AG, Basel.
Συγγραφείς:
Katoulis, A. C.
Stavrianeas, N. G.
Panayiotides, J. G.
Bozi,
E.
Vamvasakis, E.
Kalogeromitros, D.
Georgala, S.
