Fractional Photothermolysis for Treatment of Poikiloderma of Civatte

Poikiloderma of Civatte refers to a change in the skin where there is atrophy, hyper- and hypopigmentation, and dilation of fine blood vessels (telangiectasia). These alterations often cause cosmetic disfigurement, most commonly in middle-aged or elderly women with a fair complexion. Several treatment modalities, based on the theory of selective photothermolysis, including argon lasers, KTP lasers, pulsed dye lasers, and intense pulsed light devices, have been used to treat this condition in the past. Clinical experience has shown that complete clearing is difficult to achieve. Moreover, depending on the modality used, adverse effects, such as scarring with irregular hypopigmentation, post-inflammatory hyperpigmentation, post-treatment purpura, mottled appearance, crusting, and erythema, have been reported. Multiple sessions with these treatments are usually necessary to obtain optimal clearing.