Dermatoheliosis

The New England Journal of Medicine published this shocking photo of a 69 year-old man who suffered from unilateral dermatoheliosis: severe damage from excessive sun exposure (from ultraviolet rays) on one side of his face. The unnamed man told researchers that he had driven a delivery truck for twenty-eight years. Ultraviolet A (UVA) rays had penetrated his truck’s window glass, damaging the outermost skin layers and sublayers of the left side of his face. Whereas the right side of his face was protected from being inside the truck, away from the direct sunlight. We can clearly see that the side of his face that was exposed to more sunlight over the course of the past three decades displayed more signs of photo-aging, which ultimately led to this pronounced skin thickening and sagging, due to the destruction of the elastic fibers.

The use of sunscreen protection, topical retinoids, and periodic monitoring for skin cancer were recommended for this patient. This can work as an excellent reminder for us to apply sunscreen anytime we go out in sunlight. Studies from the past several years have also shown a significant association between use of an indoor tanning facility and an increased risk of basal cell carcinoma, squamous cell carcinoma, and melanoma. Although UVA is generally far less carcinogenic than UVB radiation, it is present more abundantly in sunlight than UVB radiation (> 20 times radiant energy) and can, therefore, contribute appreciably to the carcinogenicity (cancer causing ability) of sunlight. Bare in mind, skin cancer incidence is higher than that of any other human malignancy!