title: Poikiloderma vasculare atrophicans showing features of ashy dermatosis in the beginning.
abstract: Poikiloderma vasculare atrophicans (PVA) is a rare poikilodermatous variant of early-stage mycosis fungoides characterized by generalized poikiloderma, atrophy, mottled dyspigmentation, and telangiectasia. In 2001, a 14-year-old male presented with asymptomatic brownish-gray polymorphic macules throughout the body with flexural accentuation. A skin biopsy showed increased melanophages with focal hydropic changes. Ashy dermatosis was considered a possible diagnosis. In 2005, the lesions began to show darkening and lichenification in the lower part of the trunk. In 2011, his skin showed definite poikilodermatous changes, and a biopsy showed band-like inflammatory infiltrations of atypical lymphocytes, epidermal atrophy, and epidermotropism of predominantly CD4(-)CD8(+) atypical T cells. In addition, results of T-cell receptor gene rearrangement analysis were positive. Based on the aforementioned findings, he was diagnosed with PVA. If a patient shows long-standing and progressive hyperpigmentary skin changes, periodic follow-up and repeated skin biopsies are recommended to determine the underlying condition.
authors.affiliation: Department of Dermatology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jiehyun
authors.initials: J
authors.lastname: Jeon
authors.affiliation: Department of Dermatology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Joo Ha
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Ahn
authors.affiliation: Department of Dermatology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Hae Jun
authors.initials: HJ
authors.lastname: Song
keywords: CD4; CD4-CD8 ratio; CD8; Mycosis fungoides; Poikiloderma; T-lymphocytes
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