Sunday, March 09, 2008

What's a liver spot?

I recently spoke at a training session for the DermAnalysis scanner. This gizmo uses black light (UVA) to highlight areas of sun damage and dryness. The scanee sticks her head under a drape, screams with horror to discover her entire face lit up with blotchy purple and orange sun-ravaged areas, then jerks herself free of the machine seeking soothing explanations from the screener. While this UV scan cannot diagnose skin cancer, it certainly facilitates discussion of skin care.

Here's a brief lexicon of skin destruction:

Solar Lentigines: A fancy name for liver spots (aka horrid age spots) which have absolutely nothing to do with the liver whatsoever. They are, instead, the result of sun-deranged melanocytes overproducing the skin pigment called melanin. Some of these skin melanocytes just give up after years of tanning and quit producing melanin at all, resulting in white patches (see below).

There are a couple of remedies for an ugly lentigo, none of which include bleaching. A prescription product called Solage applied twice daily will fade these hummers. Melanocytes hate to be frozen, so liquid nitrogen will also work.

Idiopathic guttate hypomelanosis: A big name for tiny white spots on sun-damaged skin. Age plus sun equals death to certain touchy little groups of melanocytes. Nothing to be done about them.

Solar elastosis: This is basically at the root of this skin aging thing. Sunshine--right, the very sun you sought in college as you slathered on the baby oil and placed a reflector beneath your neck--causes breakage and clumping of the elastic fibers in the skin. As a result, skin sags and the superficial layers of the epidermis bunch up.

Cutis rhomboidalis: Talk about feeling bad about your neck! Think the deeply plowed neck skin of Midwestern farmers and ranchers. Crisscrossing furrows through thick yellowish skin. No cure for this, grow your hair long.

Poikiloderma of Civatte: I don't know who this Civatte fellow is, but this condition equals a combination of all of the above sun mess plus dilated capillaries on the anterior chest of women who faced up to the sun many times too often. No more decolletage for Suzanne Somers on those infomercials!

Seborrheic keratoses: These are big scary variegated growths that typically appear on the torsos of aging susceptibles (if you can picture these on your parents skin, you're on your way to growing your own). They have a 'stuck-on' warty appearance, and can grow to alarming proportions. Not to worry. Not dangerous from a skin cancer point of view, but distressing nonetheless. They can be surgically removed.

And here's the rest of the tour:

Crow's feet result from overuse of the orbicularis ocli muscles that activate when you crinkle your eyes during really big smiles. Furrowed brows result from chronic worry creasing your forehead. Marionette lines crease the skin from the angles of the lips to the jawline. Angular cheilitis results from really big marionette lines, perhaps coupled with loss of teeth collapsing cheeks further, resulting in folds at the lip angles that fill with saliva and residual toothpaste. This irritating ooze from mouth leads to red and painful inflammation.


dorsey said...

lentigo can also be helped by daily applications of aloe vera. wish the rest were as simple.

Ruth said...

I would have loved to hear this lecture! Gross!! But I would likely be laughing. Angular cheilitis and all those other scary names. Liver spots sound tame. Keep me away from that scanner please.

Peggikaye said...

Former extreme sun worshipper here.
Baby oil (complete with iodine in it. Don't know if that really did anything, but ..we were told it did, so anything we believed gave us a darker tan, we did).

I even went so far as ..when I graduated high school ...getting a graveyard shift job so I could ... SLEEP IN THE SUN!!! I kid you not. I'd come home, get in my swim suit and spend the day asleep in the yard.

from May to October. From age 18 to 24 (at age my 24 my dad got melanoma ...brought an immediate end to my sun worship)

I would purposefully burn, because I didn't peel ... I'd burn, then it would turn into the darkest tan. (Irish/American Indian heritage ..gave me a super white during the winter, and uber dark during the summer)

Just got a new dermatologist, she used one of those lights on me. Didn't show me the results, but wrote something on my chart about severe something or other. Then, with my history of lupus and skin cancer (both melanoma and basel cell carcinoma as well as several pre cancerous moles) STRICT orders to NOT be in the sun ...
Stuck me on plaquenil for the lupus ... and then ORDERED me again to not be in the sun ...

Then sat me down to make sure I understood ... SUN WAS FORBIDDEN.

Ok, I get it, sun not allowed.

Lupus, Plaquenil, Cellcept sun ... history of skin cancer in family ... history of skin cancer in self .. no sun.

She said to get a big floppy hat. That's not going to happen. I look terrible in hats.