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In addition to increasing the risk of skin cancer, sun exposure is also a risk factor for many other diseases affecting various parts of the body. The list below is a brief overview of some of these conditions.
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Venous lakes are caused by the dilation of superficial blood vessels.
They usually present as small soft blue or purple papules most often seen on the lower lip. They can also be seen on the earlobe, face, neck, or upper trunk.
Chronic ultraviolet ray (UVR) exposure can lead to the formation of venous lakes
The combination of solar comedones, dermatoheliosis and solar elastosis (solar elastosis - pathology term for chronic sun skin damage) is known as Favre-Racouchot Syndrome.
Solar comedones are small skin-coloured papules that can be open (blackheads) or closed (whiteheads). They are seen on areas of the face that have been exposed to the UV rays for a long time and classically over the cheekbones.
Dermatoheliosis is a process by which the skin is damaged by the sunlight and results in yellow discoloration and thickening of the skin, accompanied by deep furrows. Solar elastosis is a term used by pathologists to describe sun damages skin.
chronic ultraviolet ray (UVR) exposure can lead to the development of Favre-Racouchot syndrome
Solar lentigines commonly start appearing in the 4th and 5th decade of life and are often referred to as “age spots”.
Solar lentigines are darker patches of the skin most seen on the face. Once they appear, solar lentigines persist throughout life, and do not fade. This is different then freckles that appear in the summer and fade in winter.
sun exposure can lead to the formation of solar lentigines over time. In addition, these patches become darker and more apparent with sun exposure.
Many external factors contribute to skin aging, including UV exposure, smoking, and pollutants. Sun damage, also known as photoaging, mostly affects individuals with light skin tones, who had prolonged exposure to sunlight or artificial tanning. Certain genetic predispositions can also contribute to photoaging.
Signs of photoaging include wrinkling, discoloration, thinning, and roughness of the skin. Skin can take on a leathery appearance with deep ridges and furrows. New blood vessels (telangiectasia), as well as benign (non-cancerous) and malignant (cancerous) skin lesions may start to develop on sun-exposed areas. The skin changes associated with photoaging are highly variable from one individual to another.
with chronic sun exposure, the DNA in your skin cells gets damaged. This process leads to a skin that appears to be older than it actually is. See our article and striking images of photoaging.
Melasma is a chronic acquired skin condition that is more common in women and in individuals with brown skin. Risk factors include UV exposure, pregnancy, hormonal treatments (e.g., “the birth control pill”), certain medications, and endocrine disorders (hypothyroidism). Sometimes it is referred to as the “mask of pregnancy” because it appears due to hormonal changes of pregnancy with the sun exposure.
Melasma presents as symmetric dark macules and patches with irregular borders, most commonly seen on the face.
UV ray exposure is the most important and avoidable risk factor for developing this condition. In addition, sunlight can darken these macules and patches, making them more apparent.
Rosacea is a transient, reoccurring, or persistent red rash that primarily affects individuals with fair skin and light eyes between the ages of 30 and 60.
Genetics, alteration in the immune system, environmental triggers, and vascular and inflammatory factors all play a role in the development of rosacea. In particular, UV ray exposure resulting in chronic skin damage can worsen rosacea.
The rash can be exacerbated by many factors, including heat, alcohol, hot and spicy foods or drinks. However, the most common trigger or aggravating factor of rosacea is the sun!
The rash is typically red or pink in colour and primarily affects the central portion of the face, although it can also rarely be seen on the trunk and upper extremities. The affected areas may also have scaling and swelling. Small dilated blood vessels, called telangiectasia, can also be seen. Some people may get rosacea confused with acne. However, these two skin diseases can be differentiated by the fact that there are no comedones (white heads and black heads) in rosacea. There are 4 main subtypes of rosacea:
Sun exposure is a risk factor and known trigger/aggravating factor for the development of rosacea
Lupus erythematous (LE) is a chronic inflammatory disease that is part of a disease family called connective autoimmune tissue diseases. It is caused by a dysregulation of the immune system and can affect many organs including the kidneys, lungs, joints, heart, blood, and the skin.
Risk factors for developing lupus include: female sex, sun exposure, smoking, individuals that are genetically predisposed to developing the skin condition, and having fair skin.
When lupus affects the skin, it is called cutaneous lupus. Cutaneous lupus can present with specific features:
Note! lupus can also present with other skin findings that are non-specific for it, meaning that they can also be present in other skin diseases.
Sun exposure is a risk factor and known trigger/aggravating factor for the development of rosacea
Dermatomyositis is an inflammatory disease that affects the skin and muscles. It is part of a disease family called Connective autoiimune tissue diseases. This disease is more common in women and usually develops between the ages of 50 and 70. This condition can be a sign of internal malignancy. Risk factors include genetic predisposition, dysregulated immune system, underlying cancer, infections, and certain medications.
A violaceous rash (like the color of the heliotrope flower, shown below) can develop on the central face and eyelids, called ‘heliotrope rash’. This rash is often accompanied by swelling of the eyelids. Individuals with dermatomyositis can also have skin changes on various other parts of their body that are discussed in other sections.
sun exposure can trigger and worsen the heliotrope rash of dermatomyositis
Hydroa vacciniforme is a skin rash that is caused by an increased reactivity of the skin to sunlight. It most commonly affects children.
Hydroa vacciniforme presents as recurrent small bumps and fluid-filled blisters on areas that are commonly exposed to the sun, such as the face, arms, hands and lower limbs. The rash can be accompanied by an itching or burning sensation and can leave small concave scars once it heals.
Sun exposure causes the skin lesions to appear, and typically develop 30 minutes to 2 hours after being in the sun.
Colloid milium is a degenerative disease where deposits accumulate in the dermis, which is a deep layer of the skin. Risk factors include being male, fair skin, having an outdoor job, and exposure to extensive sunlight and certain chemicals. Colloid milium can also be seen after using certain medicated creams, such as hydroquinone.
Colloid milium typically presents with yellowish-brown, semi-translucent bumps and areas of raised skin. Each individual lesion usually measures between 1 and 4 mm. These skin findings are seen on sun exposed areas, and there can be a change of colour surrounding the affected skin (dyspigmentation)
sun exposure is a risk factor for developing colloid milium.
Poikiloderma of Civatte is caused by skin atrophy leading to hypopigmentation or hyperpigmentation of the skin, along with dilation of small blood vessels of the skin on the neck.
These present as flat patches ranging from red to brown in color develop on the skin in sun-exposed areas of the sides of the neck as well as the cheeks. Importantly, the skin under the chin is spared, as shown! This is generally a painless condition; however, some people might feel itching or burning in the affected areas.
Chronic sun exposure can lead to the development of Poikiloderma of Civatte
Cutis rhomboidalis nuchae develops as a result of the degeneration of elastin and collagen fibers in the skin due to chronic ultraviolet radiation exposure.
This presents as thickening and yellowing of the skin on the back of the neck leading to “leather-like” creases and folds.
Chronic sun exposure can lead to the development of Cutis rhomboidalis nuchae
SCLE is a subtype of Cutaneous Lupus Erythematosus (LE) which is a chronic inflammatory disease that is part of a disease family called connective autoimmune tissue diseases. It is caused by a dysregulation of the immune system and can affect many organs including the kidneys, lungs, joints, heart, blood, and the skin. The SCLE subtype usually affects only the skin.
SCLE develops in sun-exposed areas as red, scaly papules that group together to form circular plaques, and heal without scarring.
Sun exposure can cause these lesions to appear and can aggravate existing lesions.
Many of us have experienced it or know people who had this condition – “transient allergy to the sun”. PMLE is hypersensitivity reaction that occurs in sun exposed areas of the skin due to ultraviolet radiation. It is particularly common in the spring and summer in fair-skinned individuals who live in areas that don’t receive year-long sun (such as Northern Europe)
This occurs during the first strong sun exposure in the spring or summer or during a winter vacation. As the word “polymorphic” suggests, these rashes can take on many shapes and sizes, however, generally appear as groups of small pink or red papules (~2-5 mm each in size) on the chest. It can also present as dry patches, plaques, or blisters. Interestingly the face is often not affected as it usually receives enough sun even during the winter months.
These lesions appear after several hours of sun exposure and can persist for a few days to weeks.
Solar urticaria is an allergic reaction of the skin to ultraviolet radiation from the sun. It happens year round and does not fade away. Affected individuals usually have to cover their skin completely to avoid any sun contact with the skin.
Solar urticaria presents as red, itchy hives or wheals on sun exposed skin.
These lesions appear after less than 30 minutes of sun exposure. Once you leave the sun, the rash will quickly disappear in a few minutes to hours.
Dermatomyositis is an inflammatory disease that affects the skin and muscles. It is part of a disease family called Connective autoimmune tissue diseases. This disease is more common in women and usually develops between the ages of 50 and 70. It can be a sign of an internal cancer. Risk factors include genetic predisposition, dysregulated immune system, underlying cancer, infections, and certain medications.
This condition presents as flat, itchy patches are red to purple in color occurring on sun exposed areas of the skin.
Sun exposure can trigger and aggravate the rash.
Pityriasis Rubra Pilaris is a rare skin disorder with several subtypes, for which the cause is not yet known.
PRP presents as itchy, well-defined scaly, flat patches that are orange to red in color, with surrounding areas of normal skin. The palms of the hand and soles of the feet become orange in appearance, cracked and can be very painful.
Sun exposure is a trigger and an aggravating factor for this rash
Senile purpura generally affects individuals aged 60 and over and occurs in chronically sun-exposed areas where the skin and blood vessels have become thin and fragile over time.
With small trauma (such as knocking your leg or arm against a piece of furniture), small, well-defined, flat bruises that are dark purple in color appear and can take several weeks to heal.
Chronic sun exposure can render the skin more fragile, making it more susceptible to senile purpura.
SCLE is a subtype of Cutaneous Lupus Erythematosus (LE) which is a chronic inflammatory disease that is part of a disease family called connective tissue diseases. It is caused by a dysregulation of the immune system and can affect many organs including the kidneys, lungs, joints, heart, blood, and the skin. The SCLE subtype usually affects only the skin.
SCLE is a subtype of Cutaneous Lupus Erythematosus (LE) which is a chronic inflammatory disease that is part of a disease family called connective tissue diseases. It is caused by a dysregulation of the immune system and can affect many organs including the kidneys, lungs, joints, heart, blood, and the skin. The SCLE subtype usually affects only the skin.
Sun exposure can cause these lesions to appear and can aggravate existing lesions.
Porphyrias are metabolic conditions affecting the red pigment that is found in red blood cells of the body. PCT is the most common kind of porphyria and affects only the skin.
In PCT, the skin becomes very sensitive to the sun, leading to blistering, crusting, and hyperpigmentation of the skin, particularly on the forearms and the back of the hands.
Sun exposure induces blisters to appear as part of this skin disease.
Solar urticaria is an allergic reaction of the skin to ultraviolet radiation from the sun.
Solar urticaria presents as red, itchy hives or wheals on sun exposed skin.
These lesions appear after less than 30 minutes of sun exposure. Once you leave the sun, the rash will quickly disappear in a few minutes to hours.
Dermatomyositis is an inflammatory disease that affects the skin and muscles. It is part of a disease family called Connective autoimmune tissue diseases. This disease is more common in women and usually develops between the ages of 50 and 70. Risk factors include genetic predisposition, dysregulated immune system, underlying cancer, infections, and certain medications.
The Holster sign is a skin change that occurs on the hips and outer thighs, usually affecting both sides in a symmetrical fashion. The lesions are flat and reddish-purple in color and can occur in a net-like pattern.
Sun exposure can trigger and exa cerbat e the rash.
Actinic prurigo is a skin condition that is caused by an abnormal reaction to sunlight. It can affect individuals of all ages but is most commonly seen in those with darker skin types.
The rash consists of small, red, itchy bumps on sun exposed areas, such as the cheeks, nose, forehead, chin, lips, upper chest, arms, and hands. Crusts or scabs can be seen over the rash secondary to scratching.
Sun exposure induces this skin condition. The rash usually appears hours to days after exposure to the sun.
Solar urticaria is an allergic reaction of the skin to ultraviolet radiation from the sun.
Solar urticaria presents as red, itchy hives or wheals on sun exposed skin.
These lesions appear after less than 30 minutes of sun exposure. Once you leave the sun, the rash will quickly disappear in a few minutes to hours.