Drs. Jennifer R.S. Gordon and Joaquin C. Brieva of Northwestern University described a case study in the New England Journal of Medicine that caught my attention. A 69-year-old man presented with an asymmetrical thickening and wrinkling of the skin on the left side of his face. The patient reported that he had worked as a delivery truck driver for the past 28 years.
Because of copyright laws, I can not post the picture of this patient’s face. To view a picture at The New England Journal of Medicine website, click here.
The doctors diagnosed their patient with unilateral dermatoheliosis which is a term for photoaging in which the skin is chronically exposed to Ultraviolet A (UVA) rays. UVA radiation penetrates deeper that UVB radiation damaging the epidermal and dermal layers of the skin. The dermis contains three main components – elastin, collagen, and an extrafibrillar matrix – which provides structural support to the skin. When damaged, the dermis reduces in size thereby causing the epidermis to droop – thick of a balloon that’s lost air. As a measure of defense against chronic sun exposure, the epidermis of the skin will thicken and lose elasticity.
Many people don’t realize that Ultraviolet A (UVA) rays penetrate through window glass; therefore, even when driving in your car, you still need to use protection from the sun. This case study is a great example of how damaging the sun can be even through glass.
Gordon, J.R.S and J.C. Brieva. Unilateral Dermatoheliosis. N Engl J Med 2012; 366:e25. (2012)