Poikiloderma is a change in the color of the skin. People who develop poikiloderma have spots of discolored skin which can vary widely in hue. There are a number of reasons why people can develop this distinctive skin discoloration and usually a dermatologist will need to evaluate a patient to provide a diagnosis. It is important to see a medical professional for changes in skin color or texture because they can be a sign of malignancies.
In someone with poikiloderma, both hypopigmentation and hyperpigmentation can be observed. Hypopigmentation is characterized by spots which appear lighter than the surrounding skin and may be white, pinkish, or pale brown, depending on the skin color of the patient. In hyperpigmentation, the skin darkens. Many patients also have enlarged capillaries in the affected area, a condition known as telangiectasia. The skin can also be reddish, a symptom known as erythema, and the patient's skin may itch, burn, or hurt.
One common reason for poikiloderma is prolonged sun exposure, especially in areas where the ozone layer is thin. Known as sun aging or poikiloderma of Civatte, this type of poikiloderma is often seen around the face and on the arms. Over time, the skin gradually darkens as a result of sun exposure. Often the area under the chin remains pale because it is shaded from the sun. This discoloration is not dangerous but some patients may feel that it is unsightly and seek treatment to resolve the discoloration.
Changes in skin color can also accompany cancers, certain congenital conditions, and several diseases which lead to variances in skin color. If a patient presents with a skin disorder which is believed to be poikiloderma, a dermatologist may take a scraping for examination under a microscope in a pathology lab. The doctor will also typically interview the patient to collect information about other symptoms the patient may be experiencing and additional tests may be recommended if the doctor suspects that the poikiloderma is caused by an underlying medical issue.
Treatments for poikiloderma can include laser therapy which reduces the discoloration, along with topical medications to soothe skin which may be itchy or irritated. If the discoloration is caused by another medical problem, sometimes treating that will resolve the discoloration as well. In cases where poikiloderma is accompanied with malignancies, surgery may be required to remove the cancerous growths before they have an opportunity to metastasize to other areas of the body.