Unusual Sounding Dermatological Conditions

There are more than 3000 skin conditions known to dermatology, many of which have long complicated names of Latin or Greek origin. This makes Dermatology as a subject more difficult for the lay public or non- Dermatologists to understand. Below are a few such Dermatological conditions.

Poikiloderma Of Civatte

Poikiloderma of Civatte is a common skin disorder characterized by mottled pigmentation, thinning of the skin, and broken blood vessels that occur mainly on the neck and V of the chest. There is often a pale area in the shadow under the chin. It usually occurs in women over the age of 40 with paler skin.

It is caused by chronic sun exposure and aggravated by the use of fragranced products in this area.

Treatment is difficult but the most important step to prevent the condition from getting worse is sun avoidance and the regular use of a high-factor, broad-spectrum sunscreen that is fragrance-free.

If there is a small area of mainly the red type of poikiloderma, Intense Pulsed Light (IPL) may produce some improvement.

As there is always associated sun damage a special neck cream that contains growth factors and peptides would help for the sun damage but will not take away the red broken capillaries or pigmentation.

Favre-Racouchot Syndrome

This syndrome is characterized by the development of yellowish, leathery skin, deep lines, blackheads, and whiteheads over the temples of older males with a fair complexion. It is caused by damage to the collagen and elastin fibres in the dermis of the skin by chronic sun exposure. The skin is often dry.

Treatment would include sun avoidance, and the use of a high-factor broad-spectrum, hydrating sunscreen.

Manual extractions of the comedones by a qualified skin therapist are also useful. A cream that contains Retinol would help for photo-ageing and would help to prevent the formation of more blackheads and whiteheads.

Acne Excorie

This is a sub-type of acne where there is excessive picking, squeezing or fiddling with the acne lesions. In some people picking off the skin is just a subconscious bad habit but in others, it is maybe a sign of underlying anxiety or depression.

Because the skin has been scratched open, these people are often more intolerant of topical products such as Retinol. If the acne excorie is more severe, there is often secondary bacterial infection so it may be necessary to prescribe an oral tetracycline antibiotic for a month or two.

People with this condition need to cleanse their faces with a gentler cream cleanser and avoid toners and scrubs.

A topical spot treatment that contains benzoyl peroxide can also be useful.

Eczema Craquele

This is a common condition, especially in older patients where one gets dry, cracked skin especially on the lower legs that looks like crazy paving. It often occurs in the winter months and is associated with the over-washing of the skin with perfumed, alkaline bath soaps. Many people get into the habit of cleansing their bodies with the same alkaline bath soap for years but do not realise that their skin becomes more dry and sensitive with age. These harsher alkaline soaps might be tolerated by a 20-year-old but not a 70-year-old.

Treatment includes only cleansing with a creamier cleanser that is as close to pH5.5 as possible and applying liberal amounts of body moisturiser immediately after bathing or showing.

Keratolytic Winter Erythema

Also known as Oudtshoorn Disease Or Mostert’s Se Vel. This is a unique genodermatosis that was brought into this country by a French sea captain, Francois Renier Duminy, who settled in the Genandendal area in the Western Cape. People with this condition present with redness and peeling of the skin on the palms and soles of the feet, especially in winter. As this is a purely genetic condition there is, unfortunately, no cure as such. Healing balms such can be applied to the red, peeling skin:

Pityriasis Sicca Alba

Pityriasis alba is a low-grade type of eczema/dermatitis mainly seen in children that is often misdiagnosed. The name describes its appearance: pityriasis refers to the characteristic fine-scale and alba to its pale colour (hyperpigmentation).

The cause of pityriasis alba is unknown and often coexists with dry skin and tends to occur in people who are prone to asthma, hayfever and eczema.

Use a gentle creamy cleanser as close to the pH of 5.5 as possible and a soothing, hydrating moisturiser indicated for the targeted area.

Images courtesy of DermNetNZ.org & Dr Ian Webster.