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Solar elastosis (actinic elastosis) - Skin
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Solar elastosis (actinic elastosis) - Skin

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Solar elastosis (actinic elastosis) is a common manifestation of chronic sun exposure and is a form of dermatoheliosis, or photoaging. It refers specifically to the histologic observation of massive deposits of amorphous, yellow, elastin-like ("elastotic") material in the upper dermis that does not form functional elastic fibers.

Clinically, solar elastosis presents as yellow, thickened, coarsely wrinkled skin in a photodistribution. The skin can be both hyper and hypopigmented with scattered lentigines and flat seborrheic keratoses and flat pseudoscars on the forearms. Telangiectasias can be prominent, especially over the cheeks. Depending on the degree and amount of cumulative sun exposure, the findings can start to be observed in the third decade with gradual progression over the years. Fair-skinned individuals with a significant history of sun exposure are the highest risk group.

There are many clinical variants of solar elastosis including, but not limited to, cutis rhomboidalis nuchae, Favre-Racouchot syndrome, colloid milium, actinic comedonal plaque, actinic granuloma, elastotic nodules of the ear, arcus senilis, striated beaded lines, keratoelastoidosis marginalis, diffuse elastoma, and elastotic bands.

Solar elastosis is often associated with other signs of photoaging and malignant/premalignant lesions induced by ultraviolet radiation. It is chronic and progressive, correlating in severity with the degree of sun exposure.

Codes

ICD10CM:
L57.8 – Other skin changes due to chronic exposure to nonionizing radiation

SNOMEDCT:
43982006 – Solar degeneration

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis includes the clinical spectrum of solar elastotic syndromes as mentioned above, as well as:

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Management Pearls

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Therapy

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References

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Last Updated: 09/27/2016
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Solar elastosis (actinic elastosis) - Skin
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Solar elastosis (actinic elastosis) : Dorsum of hand, Forearm, Neck, Thickened skin, Yellow color, Sun-exposed distribution, Skin atrophy, History of severe sunburns, Cheeks
Clinical image of Solar elastosis (actinic elastosis)
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