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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
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I have a splotchy red rash on both sides of my neck. My dermatologist

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I have a splotchy red rash on both sides of my neck. My dermatologist didn't seem to knwo what it was and wanted to biopsy it. Since it's not raised she was going to make an incision and I'd have to have stitches...seems extreme to me. It's on both sides of my neck. Its a series of small red ciclular spots covering most fo the fron/sides of my neck. It's not raised, it's not puss filled and it's not itchy. It slmost appears like flushing. I do drink alcohol, 2-3 drinks most days. I'm not on any prescription drugs and not on any form of niacin. I feel fine but its a bit embarrassing...any thoughts would be greatly appreciated.

dermdoc19 :

Hell

dermdoc19 :

Would you be able to provide a photograph?

Customer:

I could try to text one to you Doctor

dermdoc19 :

Fine

Customer:

What number? I'll have my girlfriend take it and we'll send it asap

Customer:

doc?

Customer:

dermdoc19, are you there? I have a couple of pictures I'm ready to send you...thanks.

dermdoc19 :

Feel free to send it by clicking on the paper clip icon and up0loading.

Customer:

Full Size Image

Customer:

other side...

Full Size Image

dermdoc19 :

Hello

dermdoc19 :

This appears to me to be poikiloderma of Civatte,

dermdoc19 :

This is a harmless rash, not to be confused with other types of poikilodermas.

dermdoc19 :

Felt to be caused by a sun reaction. It may also blend in with a berloque dermatitis, if you have been using cologne in this area.

dermdoc19 :

The best treatment is probably with intense pulsed light in the green spectrum.

Customer:

OK, I googled it while waiting for you to finish typing and I agree. In my serches of skin conditions it is never listed as one of the more common conditions (psoriasis, exzema, acne etc. it what 90% of the literature is about). The photos I saw when I goodled poikiloderms of civatte exactly match what my neck looks like. Thank you so much! You managed to provide a better diagnosis with less waiting from a grainy cell phone picture than my dermatologist could do, in person, after I waited almost two hours! Is the light therapy fairly effective? Not that I'm vain or anything (OK, maybe a little)...thanks doc.

dermdoc19 :

It is but you have to turn up the fluences (energy). You are to treat brown patches pretty easily at a lower fluence, but need a higher fluence to get rid of the red. A pulsed dye laser also will work but not as well in my opinion, little more risky and more epensive, so I would stick to the IPL

Customer:

Extremely helpful- thank you doctor!

dermdoc19 :

You are welcome.

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