Poikiloderma vascular atrophic: causes, symptoms, diagnosis, treatment

Poikiloderma vascular atrophic (syn: yakobi's phylorodermia, erythematous maternal atrophoderma atrophy, etc.) is clinically manifested by a combination of atrophic skin changes, de and hyperpigmentation, spotted or mesh hemorrhages and telangiectasias, which gives the skin a distinctive "motley" appearance. The most significant changes are observed on the face, neck, upper half of the trunk and extremities, but the process can be universal. Skin is dry, wrinkled, scaly, hair falls out. Sometimes it is a mild itching. When poikilodermii Sivatta affected the lateral surface of the neck and upper chest. Poikilodermia caused by X-rays is limited to the site of irradiation.

Pathomorphology. Histological changes in the skin with different types of vascular poikilodermia are identical. In the early, erythematous, stage in the epidermis, moderate atrophy with smoothing of the epidermal outgrowths and hydrophilic dystrophy of the basal layer cells is revealed. In the upper part of the dermis is a rather dense band-shaped infiltrate of lymphocytes with an admixture of histiocytes and melanophages containing a large amount of pigment. Cells of infiltration sometimes penetrate into the epidermis. Capillaries expanded, collagen fibers edematous, locally homogenized. The sebaceous glands and hair are absent. In the late stage of the process, the epidermis is atrophic, basal epithelial cells vacuolated, inflammatory infiltrates insignificant, they contain many melanophages. Similar changes occur in scleroderma, but with the last dermis thickened. When poikilodermia, combined with mushroom mycosis, histological changes in the dermis correspond to the picture of mushroom mycosis. In contrast to lupus erythematosus, which is accompanied by vacuolization of the basal layer cells, the infiltrate in vascular poikilodermia is striped and very shallow.

Histogenesis. There is a point of view about the independence of this form of skin atrophy (idiopathic form), but most authors consider it as a phase or outcome of a wide variety of pathological conditions: dermatomyositis, lupus erythematosus, scleroderma, lymphogranulomatosis, fungal mycosis, parapsoriasis and other chronic dermatoses, including some genodermatosis. They can develop under the influence of physical factors - ionizing radiation, low and high temperatures, as well as chemical effects of oil distillation products, drugs, especially arsenic-containing. Contribute to the emergence of diseases and hormonal dysfunction, malabsorption, the role of alloimmune reactions is possible.

[1], [2], [3]