Department of Dermatology, University of Michigan, Ann Arbor, Michigan.
Department of Pathology, University of Michigan, Ann Arbor, Michigan.
J Am Acad Dermatol. 2019 Aug;81(2):480-488. doi: 10.1016/j.jaad.2019.03.081. Epub 2019 Apr 5.
Exposure to the sun causes premature skin aging, known as photoaging. Clinical features of photoaging vary widely among individuals. In one form, skin appears thin with telangiectasia, and in another form, skin appears thickened with coarse wrinkles. Etiologic, clinical, and therapeutic distinctions among different forms of photoaging remain largely unknown.
To characterize the clinical, histologic, and molecular features of hypertrophic and atrophic photoaging.
In total, 53 individuals were clinically classified as having primarily atrophic or hypertrophic photoaging or neither (controls). Participants' demographic and sun exposure-related lifestyle data were captured by questionnaire. Fifteen clinical features of participants were qualitatively or quantitively scored. Facial biopsies were analyzed for gene expression and histologic characteristics.
Actinic and seborrheic keratosis, telangiectasia, and prior incidence of skin cancers were statistically significantly greater and photoaging scale severity, coarse wrinkles, thickness, and sallowness were significantly reduced in atrophic versus hypertrophic groups. Histology also revealed significantly less elastotic material in atrophic photoaging. Gene expression of matrix metalloproteinases and collagens did not differ between the 2 forms of photoaging.
The study was not designed to identify other possible subtypes of photoaging.
Systematic, categorical, and quantitative clinical and histologic assessments distinguish atrophic and hypertrophic photoaging.
阳光照射会导致皮肤过早老化，即光老化。光老化的临床特征在个体之间差异很大。在一种形式中，皮肤变薄并出现毛细血管扩张，而在另一种形式中，皮肤变厚并出现粗糙的皱纹。不同形式的光老化的病因、临床和治疗区别在很大程度上尚不清楚。
描述肥厚性和萎缩性光老化的临床、组织学和分子特征。
共有 53 名个体被临床分类为主要存在萎缩性或肥厚性光老化或两者都没有（对照组）。通过问卷调查收集参与者的人口统计学和与阳光暴露相关的生活方式数据。对参与者的 15 个临床特征进行定性或定量评分。对面部活检进行基因表达和组织学特征分析。
光化性和脂溢性角化病、毛细血管扩张和先前发生的皮肤癌在萎缩性组中明显更多，而光老化量表严重程度、粗糙皱纹、厚度和泛黄在萎缩性组中明显降低。组织学还显示萎缩性光老化中弹性物质明显减少。基质金属蛋白酶和胶原蛋白的基因表达在两种形式的光老化之间没有差异。
该研究并未旨在确定光老化的其他可能亚型。
系统、分类和定量的临床和组织学评估可区分萎缩性和肥厚性光老化。
