02 June 2012

Sun-damaged skin (dermatoheliosis)

A 69-year-old man presented with a 25-year history of gradual, asymptomatic thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis... The patient reported that he had driven a delivery truck for 28 years. Ultraviolet A (UVA) rays transmit through window glass, penetrating the epidermis and upper layers of dermis. Chronic UVA exposure can result in thickening of the epidermis and stratum corneum, as well as destruction of elastic fibers. This photoaging effect of UVA is contrasted with photocarcinogenesis.
My father was a traveling salesman, selling transformers to electrical utilities.  I don't remember any facial asymmetry, but I do recall that his left elbow was always a darker color than the rest of his skin.

Photo and text from Jennifer R.S. Gordon, M.D., and Joaquin C. Brieva, M.D., published in the New England Journal of Medicine, via Neatorama.


  1. I definitely remember when I drove for a living that my right arm was browner than my left.
    At an interview the bloke asked why I wanted to be a driving instructor...and said he'd never heard the answer "So my left arm can get brown as well".

  2. I have an idea.. delivery drivers from the UK and US should swap countries every few years, just to keep things balanced :)

  3. Proper window tint cuts down on this. This is why I like my son in our family cars with tinted windows. It's not just for people wanting to look "cool". You actually are cooler, the car uses less A/C (therefore less gas), and you also get to literally "save face".

    Hard to see the downsides to having tint.

    Man this comment is just pun riddled, most unintended.

    1. "Hard to see the downsides to having tint."

      My understanding is that the presence of tint will also decrease the light transmitted through the windows at night as well, when it could result in a safety issue.

    2. There are a very wide range of tint shades that allow different amounts of light through. In fact your factory side windows are already tinted to 70% (the way the glass is made does not block the UVa & UVb), so there is no need for "limo tint". Even with another 70% tint applied (you can barely tell it's there) you still block the high 90's of the UV rays.

  4. In some states it's illegal to have tinted windows in the front windows. In Massachusetts it's okay to have tinted windows in the back, but illegal to have them in the front. This is apparently for the behalf of the police, who would be unable to see any illegal activity through a tinted windshield. And I know someone who was visiting in Pennsylvania who was ordered to pull the tinting off her windows or be arrested. There may be other states that also ban them.

  5. my friend regularly crosses state lines with window tinting that is legal in one state but not in another. He carries a letter he received from the illegal state saying he would not be ticked for following the laws of his home state. I have seen him show the letter to the local police and after reading it they did not ticket him. I had thought he was being a little silly writting a letter to ask and then carrying the answer in his glove box.

  6. not all the window glasses reflescts UVs.
    nice blog


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