title: Black light visualized solar lentigines on the shoulders and upper back are associated with objectively measured UVR exposure and cutaneous malignant melanoma.
abstract: Previous studies on the association of solar lentigines with ultraviolet radiation (UVR) exposure have been based on retrospective questionnaires about UVR exposure. We aimed to investigate the association between solar lentigines and UVR exposure in healthy individuals using objective measurements, and to investigate the association between solar lentigines and cutaneous malignant melanoma (CMM). Forty-eight patients with CMM and 48 controls that matched the patients individually by age, sex, constitutive skin type and occupation participated. Solar lentigines on the shoulders and upper back were counted and graded into 3 categories using black light photographs to show sun damage. Current UVR exposure in healthy controls was assessed by personal electronic UVR dosimeters that measured time-related UVR and by corresponding exposure diaries during a summer season. Sunburn history was assessed by interviews. Among controls, the number of solar lentigines was positively associated with daily hours spent outdoors between noon and 3 pm on holidays (P = 0.027), days at the beach (P = 0.048) and reported number of life sunburns (P < 0.001). Compared with matched controls CMM patients had a higher number of solar lentigines (P = 0.044). There was a positive association between CMM and higher solar lentigines grade; Category III versus Category I (P = 0.002) and Category II versus Category I (P = 0.014). Our findings indicate that solar lentigines in healthy individuals are associated with number of life sunburns, as well as time spent outdoors around noon on holidays and beach trips during a summer season, most likely reflecting past UVR exposure, and that solar lentigines are a risk factor for CMM.
authors.affiliation: Department of Dermatology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. luise.winkel.idorn@regionh.dk.
authors.forename: Luise Winkel
authors.initials: LW
authors.lastname: Idorn
authors.forename: Pameli
authors.initials: P
authors.lastname: Datta
authors.forename: Jakob
authors.initials: J
authors.lastname: Heydenreich
authors.forename: Peter Alshede
authors.initials: PA
authors.lastname: Philipsen
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Wulf
mesh_terms: D000328:Adult; D000368:Aged; D001415:Back / Q000473:pathology* / Q000503:physiopathology / Q000528:radiation effects; D016022:Case-Control Studies; D055615:Electrical Equipment and Supplies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007911:Lentigo / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008499:Medical Records; D008545:Melanoma / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D011874:Radiometry; D012720:Severity of Illness Index; D012782:Shoulder / Q000473:pathology* / Q000503:physiopathology / Q000528:radiation effects; D012878:Skin Neoplasms; D012879:Skin Physiological Phenomena; D013472:Sunlight / Q000009:adverse effects; D013997:Time Factors; D014466:Ultraviolet Rays; D000096142:Cutaneous Malignant Melanoma