title: Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color.
abstract: BACKGROUND
  Severe wrinkles and pigmentary changes of the exposed skin indicate substantial damage due to UV radiation. Many investigators believe that the principal manifestation of photodamage in Asians is pigmentary change rather than wrinkles. However, to our knowledge, no well-designed study has investigated the characteristics of cutaneous photodamage in Asian skin.
  
  
  OBJECTIVE
  To access the severity of wrinkles and dyspigmentation in Koreans exposed to sun and who smoked.
  
  
  METHODS
  We developed new photographic scales for grading wrinkles and dyspigmentation in 407 Koreans to assess the severity of the wrinkles and dyspigmentation. We interviewed subjects to determine cumulative sun exposure and smoking history, and measured the skin color of individual subjects.
  
  
  RESULTS
  Our photographic scales provided a reliable evaluation of photodamage severity in Koreans. The pattern of wrinkling in both sexes is similar, but women tended to have more severe wrinkles (prevalence odds ratio, 3.7). However, the pattern of dyspigmentation differed between the sexes. Seborrheic keratosis is the major pigmentary lesion in men, whereas hyperpigmented macules are the prominent features in women. Cigarette smoking is an independent risk factor for wrinkles, but not for dyspigmentation, in Koreans, and causes additive detrimental effects to wrinkles induced by aging and sun exposure. The constitutive skin color did not show any correlation with wrinkles or dyspigmentation. However, facultative pigmentation (sun exposure index) may reflect lifetime sun exposure, and it shows a good correlation with wrinkles in Koreans.
  
  
  CONCLUSIONS
  Wrinkling is a major feature of photoaging in Koreans, as are pigmentary changes; smoking, sun exposure, and female sex are independent risk factors for wrinkles.
authors.affiliation: Department of Dermatology, Seoul National University Hospital, 28 Yungon-Dong, Chongno-Gu, Seoul 110-744, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Chung
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: C S
authors.initials: CS
authors.lastname: Youn
authors.forename: B J
authors.initials: BJ
authors.lastname: Park
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.forename: K C
authors.initials: KC
authors.lastname: Park
authors.forename: K H
authors.initials: KH
authors.lastname: Cho
authors.forename: H C
authors.initials: HC
authors.lastname: Eun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D015595:Skin Aging; D012880:Skin Pigmentation; D012907:Smoking; D013472:Sunlight / Q000009:adverse effects*