• Best ResultsVariable
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistDermatology Dept.
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkNA
  • Cost$


AMCV or atrophia maculosa varioliformis cutis presents as depressed idiopathic scarring primarily affecting the face in young adults. The cause is unknown, & treatments are often unsuccessful. This is one of life’s true mysteries. Over the next few years, we will know more about this condition. It is much more common than what the literature reports.

FactsFacts On AMVC

  • This condition is more common than what is reported in the literature
  • Regardless, AMVC is a diagnosis of exclusion
  • Atrophic scars can be post inflammatory, post infectious & immune related
  • A medical dermatologist can exclude others causes mimicking AMCV
  • A biopsy can be useful in the diagnosis
  • AMVC should ideally be managed in a departmental setting in a university
  • There are no universally accepted treatments for this form of macular atrophy

What is AMCV?

This poorly understood entity was first described over a century ago. It has many forms & shapes, typically presenting as non-inflammatory shallow depressions (atrophy), typically involving the face of young adults. Fortunately, most cases are mild, hence the term macular or flat.

This entity is much more common than in the literature, however most people do not know they have it (referring to milder cases).

What causes atrophic scars from AMVC?

As with everything else that has no concrete aetiology, the probable cause is genetics, coupled with environmental changes or stimuli; epigenetics. This means your skin has a predetermined genetic mutation that is activated by a trigger. Both trigger & mutation are yet unknown.

What clinical variants are there?

Based upon the clinical reports & my experience, the following variants are reported

  • Feline variant: reported in India, linear whisker like atrophic areas around the mouth
  • Crescentic variant: common, sides of face, temples, suggestive of traumatic origin but absent history.
  • Cribriform variant: forehead. Super rare variant, hard to treat.
  • Circular variant: looks like chickenpox but no history of inflammation. Biopsy shows atrophy with no fibrosis.

I do believe that atrophoderma of Moulin is a separate entity & more towards the morphea spectrum. PIH is seen in Moulin due to dermal pigment secondary to lichenoid changes, I disagree with a paper lumping Moulin with AMVC.

Will more scars develop?

Highly unlikely. Though spontaneous in nature, the majority of AMVC cases do not get worse in time. The flipside is that established scars rarely spontaneously resolve.

Davin’s Viewpoint on Atrophia Maculosa Varioliformis Cutis

AMVC is much more common than what you believe it to be. I see at least half a dozen cases a year in private practice. Even though I can pick this up, it does not mean I have an answer. Much like other dermatologists worldwide, I do not understand this condition, & I do not have a reliable way of treating it.

The majority of AMVC I see are incidental findings as I treat these patients with severe acne scars. I often do not point out macular scarring if they do not see it. In some cases, I treat these incidental findings with low fluence fractional lasers. In some patients they respond, in others they do not.

There is an overlap between AMVC & body dysmorphic disorder. Firstly, AMVC does exist, as macular atrophic scarring can be demonstrated with examination, photography & in many cases pathology. The question of whether we treat this in private practice is debatable. My view is that only objectively severe pathology is treated. This favours the benefit: risk ratio, as compared to objectively mild, but subjectively severe pathology where the risk bit of the ratio is much higher. These patients are best managed by a team of dermatologist, psychologist & psychiatrist.

My viewpoint is not that patients with mild forms (objective mild) of atrophia maculosa should not be treated, that is not the point of the argument. This statement means that I am not the dermatologist to treat this. My work focuses on objectively severe disease. There are many other dermatologists that will take this job on. In this case, possibly the use of gentle treatments like microneedling, dermal delivery of collagen stimulating filler, conservative erbium & CO2 lasers or other fractional lasers may be a sensible option.

IMO all patients should have a biopsy (this is arranged by your dermatologist). This means specimens are collected in your country and state, providing a database for future DNA studies / genetic testing. This cannot be done in private practice as records are fragmented. One hospital, one department, all records. This aids in R & D.

The relationship between mild AMVC, BDD & dermatitis artefacta needs to be explored in more detail. Some but not all cases are DA, which projects as body dysmorphic syndrome in turn mimicking AMVC. That really sucks as these people really hamper research into this condition. I do not have an answer for this problem as it requires a multidisciplinary approach including a medical dermatologist, psychologist & psychiatrist.

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date


Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query