Cutaneous Photoaging: A Notable Pattern of Distribution of Lentigines on the Face

July 2020 | Volume 19 | Issue 7 | Original Article | 755 | Copyright © July 2020


Published online June 18, 2020

Farah A. Moustafa MDa, Abrar A. Qureshi MD MPHb, Jeffrey S. Dover MD FRCPCa,c

aSkinCare Physicians, Chestnut Hill, MA bDepartment of Dermatology, Rhode Island Hospital, Brown Medical School, Providence, RI cDepartment of Dermatology Yale University School of Medicine, New Haven, CT

Abstract
Importance: Facial lentigines are a common patient complaint encountered in general and cosmetic dermatology practices. Lentigines are a marker of photoaging and understanding their distribution will provide insight into the aging process in order to better counsel patients. Objectives: To compare the relative distribution of lentigines in facial cosmetic subunits.
Methods: We reviewed clinical photographs of patients receiving Alexandrite laser treatment for facial lentigines during the time period 11/1/2017–12/1/2018. Individual lentigines were plotted for each patient into one of 21 aesthetic units. A “heat map” was created to compare the relative density of these lesions.
Results: Grouped peripheral cosmetic subunits contained more lentigines compared to grouped central cosmetic units. The mean number of lentigines in the central units was 0.60 and in the peripheral units was 0.85. This finding was statistically significant with a p value of 0.0001.

J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.5193

INTRODUCTION

Facial lentigines are a common patient complaint in dermatology practices. Lentigines are a marker of photoaging and understanding their distribution will provide insight into the aging process. The goal of our study was to determine the distribution of lentigines on the face and to determine if distribution of lentigines corresponds to published cutaneous UV damage and skin cancer distributions.

METHODS

We performed an IRB-approved retrospective chart review at SkinCare Physicians in Chestnut Hill, MA. Eligible patients were identified by screening the electronic health record (EHR) for patients who had procedure codes for short-pulsed Alexandrite during the time period of 11/1/2017–12/1/2018. Patients who were 25–80 years-old and received Alexandrite laser treatment for facial lentigines were included. Patients were excluded if they did not have a series of high-quality photographs of the entire face. Photographs were reviewed and each patient’s lentigines were plotted on a diagram of the face divided into aesthetic units based on a modified Gonzalez-Ulloa distribution (previously used to perform studies evaluating skin cancer distribution1) (Figure 1). There was a total of 21 aesthetic units.