Photoallergic Contact Sensitization to 6-Methylcoumarin in Poikiloderma of Civatte

Vasanop Vachiramon; Penpun Wattanakrai


Dermatitis. 2005;16(3):136-138. 

In This Article

Abstract and Introduction

A 49-year-old woman presented with asymptomatic progressive erythema, hyperpigmentation, atrophy, and telangiectasia on her neck. The clinical appearance and histopathology of the skin lesion was consistent with poikiloderma of Civatte. Photopatch-testing with our standard photoallergens yielded a positive reaction to 6-methylcoumarin, which was found in the patient's perfume. This report describes the first case in which photoallergic contact sensitization to 6-methylcoumarin may play an important role in the pathogenesis of poikiloderma of Civatte.

Poikiloderma of Civatte is a benign dermatosis characterized by a combination of erythema, hyperpigmentation, atrophy, and telangiectasia. It is seen commonly on the upper chest and sides of the neck and less commonly on the lateral aspects of the cheeks, sparing the shaded area under the chin. The etiology and pathogenesis of poikiloderma of Civatte are still debated. Chronic exposure to ultraviolet light,[1] hormonal changes associated with menopause,[2,3] genetic factors,[4] and photosensitizing chemicals in perfumes or cosmetics[5] have been implicated in the pathogenesis of poikiloderma of Civatte. We report a case of photoallergic contact sensitization to 6-methylcoumarin in a patient with poikiloderma of Civatte.