Atrophia maculosa varioliformis cutis

Atrophia Maculosa Varioliformis Cutis (AMVC) is a rare dermatological condition characterized by the spontaneous formation of scars on the face. This condition is also known as "spontaneous facial macular atrophy," highlighting its primary manifestation as atrophic, varioliform (varioloid) scars without a preceding history of trauma or inflammatory skin diseases. The etiology of AMVC remains largely unknown, making it a subject of ongoing research within the field of dermatology.

Etiology and Pathogenesis

The exact cause of Atrophia Maculosa Varioliformis Cutis is currently unknown. Several theories have been proposed, including genetic predisposition, minor unnoticed trauma, changes in pilosebaceous units, and abnormal collagen formation or degradation. However, none of these theories have been definitively proven. The condition does not seem to be associated with any systemic diseases or other skin conditions, which further complicates understanding of its pathogenesis.

Clinical Features

AMVC typically presents in late childhood or early adulthood with the development of small, round to oval, atrophic, pitted scars on the cheeks, forehead, and sometimes on the temples. These scars are usually 2-5 mm in diameter and may have a slightly hyperpigmented or hypopigmented border. Unlike acne scars, AMVC occurs without any preceding acne or other known skin conditions. The development of new scars may occur over time, and the condition tends to stabilize eventually without further progression.

Diagnosis

The diagnosis of Atrophia Maculosa Varioliformis Cutis is primarily clinical, based on the characteristic appearance of the scars and the absence of a history of acne, trauma, or other skin conditions that could explain the scarring. Dermoscopy can be helpful in examining the scars more closely and ruling out other conditions. Biopsy is rarely needed but can confirm the diagnosis by showing atrophic epidermis, loss of elastic fibers, and changes in the dermal collagen.

Treatment

There is no specific treatment for AMVC, and management focuses on cosmetic improvement. Options include laser therapy, dermal fillers, and microneedling, which may help reduce the appearance of the scars. Sun protection is recommended to prevent further pigmentation changes. Patients may also benefit from psychological support, as the condition can affect self-esteem and emotional well-being.

Prognosis

The prognosis for individuals with Atrophia Maculosa Varioliformis Cutis is generally good, as the condition is benign and does not affect general health. However, the cosmetic concerns can be significant, and the spontaneous nature of the scarring can be distressing to patients.