Riehl melanosisL81.4

Author:Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

civatte disease; Civatte disease; melanosis toxica lichenoides; Poikilodermia reticularis Civatte; Poikilodermia réticulée pigmentaire du visage et du cou; Poikilodermie réticulée pigmentaire Civatte; Riehl melanosis; Riehls melanosis; Riehl Syndrome; War Melanosis

Requires free registration (medical professionals only)

Please login to access all articles, images, and functions.

Our content is available exclusively to medical professionals. If you have already registered, please login. If you haven't, you can register for free (medical professionals only).


Requires free registration (medical professionals only)

Please complete your registration to access all articles and images.

To gain access, you must complete your registration. You either haven't confirmed your e-mail address or we still need proof that you are a member of the medical profession.

Finish your registration now

HistoryThis section has been translated automatically.

Riehl, 1917; Civatte, 1923

DefinitionThis section has been translated automatically.

Inflammatory spotty pigmentation on the face, which is seen as a variant of melanodermatitis toxica.

EtiopathogenesisThis section has been translated automatically.

Unexplained, probably photosensitization of previously damaged skin. Noxae to be considered: asphalt, tars and fats (in inferior cosmetics), foodstuffs, medicines. The increased incidence of melanosis in times of war with malnutrition has also given the disease the nickname "war melanosis".

It is possible that chronic malnutrition causes a deficit of skin active substances and vitamins which can lead to pigmentation and endocrine disorders.

ManifestationThis section has been translated automatically.

Mainly occurring in adult women; also in children.

LocalizationThis section has been translated automatically.

Especially forehead, temples, cheeks, lateral parts of the neck.

Clinical featuresThis section has been translated automatically.

Symmetrically localized, blurred, initially itchy red spots. Transformation into asymptomatic, slate grey to deep brown, laminar, also reticular pigmentation.

Development of follicular or perifollicular keratoses and possibly lichenoid papules.

HistologyThis section has been translated automatically.

Cellular inflammatory infiltrate in the upper corium. Liquefaction degeneration of the basal cell layer of the epidermis. Pigmentary incontinence in the upper corium with free melanin or melanin phagocytised in melanophages.

Differential diagnosisThis section has been translated automatically.

Chloasma; Freund syndrome; melanosis perioralis et peribuccalis; incontinentia pigmenti, Bloch-Sulzberger type; incontinentia pigmenti, Franceschetti-Jadassohn type; naevus fuscocoeruleus deltoideoacromialis.

External therapyThis section has been translated automatically.

  • According to the authors, cosmetic cover (e.g. Dermacolor) and textile sun protection as well as physical/chemical sun protection (e.g. Anthelios) are the most sensible therapy approach (all year round, even during winter holidays).
  • Although the changes show a good response to the application of local bleaching agents like combined application of hydroquinone with glucocorticoids or retinoids (effect after 4 weeks at the earliest, peak after 4 months; e.g. Pigmanorm, R118 ), spotty changes of the skin as well as irreversible hypopigmentations have to be expected with this treatment. If necessary, prior testing on a small area of skin.

    Notice! Be careful when using depigmenting external agents on the face! Permanent pigment shifts may occur!

  • Therapy attempts with azelaic acid (e.g. Skinoren) 1-2 times/day, over 3-12 months have also shown success. If necessary, treatment attempts with chemical peeling or high-energy flash or short-arc lamp technology (IPL = Intense Pulsed Light).

Progression/forecastThis section has been translated automatically.

Quoad sanationem unfavourable.

LiteratureThis section has been translated automatically.

  1. Civatte A (1923) Poïkilodermie réticulée pigmentaire du visage et du cou. Ann Derm Syph Paris 4: 605-620
  2. Katoulis AC et al (2002) Evaluation of the role of contact sensitization and photosensitivity in the pathogenesis of poikiloderma of Civatte. Br J Dermatol 147: 493-497
  3. Perez-Bernal A et al (2000) Management of facial hyperpigmentation. At J Clin Dermatol 1: 261-268
  4. Raulin C et al (2003) IPL technology: a review. Lasers Surg Med 32: 78-87
  5. Riehl G (1917) About a strange melanosis. Vienna clin Wschr 30: 780-781
  6. Serrano G, Pujol C, Cuadra J et al (1989) Riehl's melanosis: Pigmented contact dermatitis caused by fragrances. J Am Acad Dermatol 21: 1057-1060

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer