ABSTRACT
Cumulative exposure to the sun can induce clinical and
histological changes in the skin, commonly called photo-
aging or dermatoheliosis. This occurs primarily in
patients with fair skin types (Fitzpatrick 1 to Fitzpatrick
3 skin types) who have experienced repeated solar
injuries over the years, such as lifeguards and outdoor
laborers. 1 Clinically, photoaging represents a polymorphic
response to sun damage that manifests variably as wrin-
kles, skin roughness and xerosis, irregular mottled pig-
mentation, telangiectasias (poikiloderma of Civatte),
actinic purpura, sallowness (also known as Milian
citrine skin), and brown macules or solar lentigines.
