DERMOSCOPIC EVALUATION OF FACIAL AGING IN FEMALES
Yasmin Ahmad Tag El-Deen Al-Zahaby;
Abstract
Skin aging is the end result of both intrinsic aging, which is the result of the passage of time, and photoaging, which refers to alterations in skin structure and function that result from chronic sun exposure, in addition to the passage of time. It is important to distinguish between chronological skin aging and photoaging.
Chronological skin aging can be summarized as atrophy with structural and functional decline of the skin. Sun-protected aged skin is finely wrinkled with exaggeration of facial expression lines, laxity, and pallor.
Extrinsic skin aging involves hypertrophy as an inflammatory, protective response to the damaging effects of UV rays. Photoaging is manifested by xerosis, leathery skin, irregular pigmentation (freckles, lentigines), and more pronounced wrinkling. Telangiectasias, purpura, comedones, and a variety of benign and premalignant skin tumors including seborrheic keratoses, sebaceous gland hyperplasia, and actinic keratoses are frequent findings. UV irradiation from the sun damages human skin, causing it to age prematurely.
Dermoscopy is an aiding diagnostic tool that allows the in vivo evaluation of colors and microstructures of the epidermis, the dermo-epidermal junction, and the papillary dermis which are not visible to the naked eye. Its idea depends on trans-illumination of a lesion and studying it with a high magnification. Old dermoscopes requires application of certain oil over the lesion to be examined while new dermoscopes are provided with polarized light, rendering the fluid placed on the lesion unnecessary for inspecting the vascular morphology of papulosquamous diseases. Dermoscopes are classified into, dermoscopes without image capturing facility, dermoscopes with image capturing facility and dermoscopes with image capture facility and analytical capability.
Dermoscopes are used mainly for the study of melanocytic nevi and melanoma. However, it can be used to diagnose other conditions too, e.g. psoriasis, lichen planus, dermatofibroma, darier's disease, cicatricial alopecia, seborrheic keratosis, urticarial vasculitis, raynaud's phenomenon, striae distensae, mucinous carcinoma, porokeratosis, clear cell acanthoma, angioma serpiginosum, solitary angiokeratoma, fibroepithelioma of Pinkus, bowen's disease, actinic keratosis, sebaceous hyperplasia, scabies, pediculosis and vitiligo.
Also some features of skin aging can be detected easily with dermoscopy. Measurement of skin aging with dermoscopy will give more reliable and objective results than the scales using clinical criteria. Prevention and treatment of skin aging can be measured with the DPAS and efficacy of many therapeutic applications can be investigated.
In this study, we assess facial aging with dermoscopy by means of DPAS criteria. Measurement of skin aging with dermoscopy will give more reliable and objective results than the scales using clinical criteria.
The purpose of this study was to evaluate facial aging in females using a hand-held dermoscopy.
Our study was carried out on 100 female participants, they were classified into 3 groups representing the forth decade, the sixth decade and beyond the sixth decade. They had clinical signs of skin aging, with Fitzpatrick skin types II, III or IV and Glogau's photoaging classification types 1, 2, 3 or 4.
All participants' facial skin will be examined by dermoscopy for signs of aging using a hand-held dermoscopy as well as the dermoscopic findings will be photo-documented by a digital camera.
Dermosopic evaluation showed that there was a highly significant difference between study groups as regards DPAS score. Also, a highly significant difference between study groups was found regarding some dermoscopic findings as; yellowish discoloration, yellow papules, telangiectasia, senile comedones, deep wrinkles and criss-cross wrinkles.
Our study showed that the most prominent dermoscopic findings according to DPAS criteria were hypo-hyperpigmented macules followed by lentigo in group I, hypo-hyperpigmented macules and superficial wrinkles in groupII, criss-cross wrinkles, yellow papules and deep wrinkles in groupIII.
Regarding other dermoscopic criteria, the following findings were detected in study groups as follows; in group I diffuse erythema (n = 6, 14.6%), in group II seborrheic keratosis (n = 3, 7.5%) and diffuse erythema (n = 3, 7.5%), in group III seborrheic keratosis (n = 3, 15.8%) and diffuse erythema (n = 5, 26.3%).
Most of the participants having skin phototypes II, III or IV, we noticed that DPAS score, telangiectasia, and senile comedones were higher in cases with skin type II and IV compared to cases with skin type III in group II.
Additionally, there was a significant difference in group III cases as regards lentigo in cases with skin type II compared to cases with skin types III and IV.
Interestingly, we noticed a statistically significant difference between smokers and nonsmokers as regards yellow discoloration and criss-cross wrinkles among group III cases.
Concerning SEI, there was a highly significant increase in DPAS score; being higher among cases with SEI 2 and a significant increase in superficial wrinkles among cases with SEI 3 in group I.
The study showed that cases with Glogau's scale 3 showed the highest DPAS score (4.2 ± 1.5 SD). On the other hand, cases with Glogau's scale 1 showed the lowest DPAS score (2.8 ± 1.3 SD).
Furthermore, there was a significant difference (p=0.037) in Glogau's scale among group I cases as regards telangiectasia with Glogau's scale 3 and there was a highly significant difference (p=0.004) in Glogau's scale as regards superficial wrinkles with Glogau's scale 3.
Among group II, the study shows that there was a highly significant difference (p=0.001) in the Glogau's scale as regards deep wrinkles with Glogau's scale 3. Also there was a significant difference (p=0.048) in the Glogau's scale as regards hypo-hyperpigmented macules with Glogau's scale 1 and there was a significant difference (p=0.05) in the Glogau's scale as regards superficial wrinkles with Glogau's scale 3.
Chronological skin aging can be summarized as atrophy with structural and functional decline of the skin. Sun-protected aged skin is finely wrinkled with exaggeration of facial expression lines, laxity, and pallor.
Extrinsic skin aging involves hypertrophy as an inflammatory, protective response to the damaging effects of UV rays. Photoaging is manifested by xerosis, leathery skin, irregular pigmentation (freckles, lentigines), and more pronounced wrinkling. Telangiectasias, purpura, comedones, and a variety of benign and premalignant skin tumors including seborrheic keratoses, sebaceous gland hyperplasia, and actinic keratoses are frequent findings. UV irradiation from the sun damages human skin, causing it to age prematurely.
Dermoscopy is an aiding diagnostic tool that allows the in vivo evaluation of colors and microstructures of the epidermis, the dermo-epidermal junction, and the papillary dermis which are not visible to the naked eye. Its idea depends on trans-illumination of a lesion and studying it with a high magnification. Old dermoscopes requires application of certain oil over the lesion to be examined while new dermoscopes are provided with polarized light, rendering the fluid placed on the lesion unnecessary for inspecting the vascular morphology of papulosquamous diseases. Dermoscopes are classified into, dermoscopes without image capturing facility, dermoscopes with image capturing facility and dermoscopes with image capture facility and analytical capability.
Dermoscopes are used mainly for the study of melanocytic nevi and melanoma. However, it can be used to diagnose other conditions too, e.g. psoriasis, lichen planus, dermatofibroma, darier's disease, cicatricial alopecia, seborrheic keratosis, urticarial vasculitis, raynaud's phenomenon, striae distensae, mucinous carcinoma, porokeratosis, clear cell acanthoma, angioma serpiginosum, solitary angiokeratoma, fibroepithelioma of Pinkus, bowen's disease, actinic keratosis, sebaceous hyperplasia, scabies, pediculosis and vitiligo.
Also some features of skin aging can be detected easily with dermoscopy. Measurement of skin aging with dermoscopy will give more reliable and objective results than the scales using clinical criteria. Prevention and treatment of skin aging can be measured with the DPAS and efficacy of many therapeutic applications can be investigated.
In this study, we assess facial aging with dermoscopy by means of DPAS criteria. Measurement of skin aging with dermoscopy will give more reliable and objective results than the scales using clinical criteria.
The purpose of this study was to evaluate facial aging in females using a hand-held dermoscopy.
Our study was carried out on 100 female participants, they were classified into 3 groups representing the forth decade, the sixth decade and beyond the sixth decade. They had clinical signs of skin aging, with Fitzpatrick skin types II, III or IV and Glogau's photoaging classification types 1, 2, 3 or 4.
All participants' facial skin will be examined by dermoscopy for signs of aging using a hand-held dermoscopy as well as the dermoscopic findings will be photo-documented by a digital camera.
Dermosopic evaluation showed that there was a highly significant difference between study groups as regards DPAS score. Also, a highly significant difference between study groups was found regarding some dermoscopic findings as; yellowish discoloration, yellow papules, telangiectasia, senile comedones, deep wrinkles and criss-cross wrinkles.
Our study showed that the most prominent dermoscopic findings according to DPAS criteria were hypo-hyperpigmented macules followed by lentigo in group I, hypo-hyperpigmented macules and superficial wrinkles in groupII, criss-cross wrinkles, yellow papules and deep wrinkles in groupIII.
Regarding other dermoscopic criteria, the following findings were detected in study groups as follows; in group I diffuse erythema (n = 6, 14.6%), in group II seborrheic keratosis (n = 3, 7.5%) and diffuse erythema (n = 3, 7.5%), in group III seborrheic keratosis (n = 3, 15.8%) and diffuse erythema (n = 5, 26.3%).
Most of the participants having skin phototypes II, III or IV, we noticed that DPAS score, telangiectasia, and senile comedones were higher in cases with skin type II and IV compared to cases with skin type III in group II.
Additionally, there was a significant difference in group III cases as regards lentigo in cases with skin type II compared to cases with skin types III and IV.
Interestingly, we noticed a statistically significant difference between smokers and nonsmokers as regards yellow discoloration and criss-cross wrinkles among group III cases.
Concerning SEI, there was a highly significant increase in DPAS score; being higher among cases with SEI 2 and a significant increase in superficial wrinkles among cases with SEI 3 in group I.
The study showed that cases with Glogau's scale 3 showed the highest DPAS score (4.2 ± 1.5 SD). On the other hand, cases with Glogau's scale 1 showed the lowest DPAS score (2.8 ± 1.3 SD).
Furthermore, there was a significant difference (p=0.037) in Glogau's scale among group I cases as regards telangiectasia with Glogau's scale 3 and there was a highly significant difference (p=0.004) in Glogau's scale as regards superficial wrinkles with Glogau's scale 3.
Among group II, the study shows that there was a highly significant difference (p=0.001) in the Glogau's scale as regards deep wrinkles with Glogau's scale 3. Also there was a significant difference (p=0.048) in the Glogau's scale as regards hypo-hyperpigmented macules with Glogau's scale 1 and there was a significant difference (p=0.05) in the Glogau's scale as regards superficial wrinkles with Glogau's scale 3.
Other data
| Title | DERMOSCOPIC EVALUATION OF FACIAL AGING IN FEMALES | Other Titles | التقييم الديرموسكوبي لشيخوخة الوجه فى السيدات | Authors | Yasmin Ahmad Tag El-Deen Al-Zahaby | Issue Date | 2015 |
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