Poikiloderma vasculare atrophicans Other names Parapsoriasis variegata [1] or Parapsoriasis lichenoides [2] Typical skin changes and discoloration described as poikiloderma vasculare atrophicans Specialty Dermatology Poikiloderma vasculare atrophicans ( PVA ), is a cutaneous condition ( skin disease ) characterized by hypo- or hyperpigmentation (diminished or heightened skin pigmentation , respectively), telangiectasia and skin atrophy . [3] [4] [5] Other names for the condition include prereticulotic poikiloderma and atrophic parapsoriasis . [6] The condition was first described by pioneer American pediatrician Abraham Jacobi in 1906. [7] PVA causes areas of affected skin to appear speckled red and inflamed, yellowish and/or brown, gray or grayish-black, with scaling and a thinness that may be described as "cigarette paper". [3] On the surface of the skin, these areas may range in size from small patches, to plaques (larger, raised areas), to neoplasms (spreading, tumor-like growths on the skin). [3] [6] Mycosis fungoides, a type of skin lymphoma , may be a cause of PVA. The condition may also be caused by, associated with or accompany any of the following conditions or disorders: other skin lymphomas, dermatomyositis , lupus erythematosus , Rothmund–Thomson syndrome , Kindler syndrome , dyskeratosis congenita , and chronic radiodermatitis . [4] Rare causes include arsenic ingestion, and the condition can also be idiopathic . [1] [3] [5] PVA may be considered a rare variant of cutaneous T-cell lymphoma , a non-Hodgkin's form of lymphoma affecting the skin. [7] It may also be included among a number of similar conditions that are considered as precursors to mycosis fungoides . PVA is believed to be a syndrome closely associated with large-plaque parapsoriasis and its cohort retiform parapsoriasis ; including PVA, all three conditions fit within an updated view of the once ambiguous classification scheme known as parapsoriasis . [5] Contents 1 Presentation 2 Cause 3 Diagnosis 3.1 Classification 4 Management 5 See also 6 References 7 External links Presentation [ edit ] The layers of the epidermis (left). Melanocytes (rlght), located in the bottom epidermal layer, produce melanin. PVA can be characterized by speckled, combined hyper- and hypopigmentation in the plaques or patches of affected skin. [5] Hyperpigmentation is excess coloration, or darkening of the skin, [8] while hypopigmentation is a diminished or pallid coloring to the skin.