Patients with the mild form do not seek medical advice. Poikiloderma of Civatte occurs most commonly in fair-skinned individuals. Poikiloderma of Civatte occurs more commonly in females than in males. Patients usually complain of chronic reddish-brown discoloration on the lateral cheeks and neck. Lesions usually are asymptomatic, but occasionally, patients report mild burning, itching, and hyperesthesia.
Lesions appear to run in line with the normal skin creases of the neck.
Areas shaded by the chin usually are spared. Chronic exposure to ultraviolet light appears to be a primary etiologic factor, which is supported by the finding that lesions occur on sun-exposed areas. In addition, solar elastosis is a frequent histopathologic finding. Photosensitizing chemicals in perfumes or cosmetics have been implicated in the pathogenesis of poikiloderma of Civatte. Possibly, hormonal changes related to menopause or low estrogen levels may be a factor.