Patients with the mild form do not even seek medical advice. Most common in fair-skinned individuals. More common in females. Patients usually complain of chronic reddish-brown discoloration on the lateral cheeks and neck. Lesions usually are asymptomatic, but occasional 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. Furthermore, solar elastosis is a frequent histopathological finding. Photosensitizing chemicals in perfumes or cosmetics have been implicated in the pathogenesis of poikiloderma of Civatte. Genetic predisposition may exist. This is supported by the presence of the condition in successive generations, and in individuals of both sexes, consistent with an autosomal-dominant inheritance with variable penetrance.