Poikiloderma Vasculare Atrophicans

IN 1906 Jacobi¹described a complex dermatologic disease characterized by telangiectasia, pigmentation and, later, capillary hemorrhages and atrophy, which he subsequently termed poikiloderma vasculare atrophicans.² In a previous report³of a fatal case in which the lesions of poikiloderma vasculare atrophicans started after exposure to sunlight, we suggested the possibility that physical factors might be precipitating causes of this disease. Other authors published reports of cases in which there was a history of exposure to cold.⁴In the cases of Montgomery and O'Leary⁵and of Ingram⁶cold intensified the erythema. Zinsser⁷attributed the disease in his patients to injury in early life of the small blood vessels on the exposed parts of the body. Kindler⁸reported a case following severe injuries from a motor accident. Many dermatologists expressed the view that the cutaneous picture of poikiloderma vasculare atrophicans might be the