Today a 34 year old male patient came to me with this well demarcated pigmentation over the neck extending to the face since 3 months. He also had few pigmented streaks over both arms. What are the differential diagnosis?

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Bell Eapen
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Techie Dermatologist, Information Systems PhD, Supporter of Open-Source Software, Machine Learning and AI geek, loves cricket, Canadian wine and beer. [Resume]


  1. Pigmentation is best managed as such with a variety of labelling options like Reihl’s melanosis,Pigmented contact dermatitis,Pigmentd LP,Erythema dyschromicum perstans,Toxic melanoderma etc.Call it whatever you want but principles of management remain the same.

  2. Poikiloderma of Civatte

    This patient is a case of vitiligo on various PUVA regimns for the past 15 years. However this lesion started 6 months back and he is not on any photo sensitizer since 2 years. I am suspecting Poikiloderma of Civatte.
    Though it is common in white skinned women, the characteristic distribution, reticulate pigmentation and the history of phototherapy points towards this diagnosis.

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