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Bill McElligott's face is a classic among dermatologists because it perfectly illustrates what happens when one does not wear sunscreen and that one leaves the sun for years.
McElligott was 69 when he took the picture, but his left side (right as you see it) looks 20 years older, with many more wrinkles, spots and loss of tissue elasticity .
McElligott presents a gradual and asymptomatic thickening of the skin on the left side of the face for 25 years. The physical examination showed hyperkeratosis with accented furrows, multiple open comedones and areas of nodular elastosis. Histopathological analysis showed an accumulation of elastolytic material in the formation of dermis and milia in the villous hair follicles.
The results were consistent with the Favre-Racouchot syndrome of photodamaged skin, known as dermatoheliosis. The patient stated that he had driven a delivery truck for 28 years. Ultraviolet A (UVA) rays are transmitted through the glass, penetrating into the epidermis and the upper layers of the dermis.
Chronic exposure to UVA can cause thickening of the epidermis and the diaper. cornea, as well as the destruction of elastic fibers. This photo-aging effect of UVA rays is contrasted with photocarcinogenesis.
Although ultraviolet B exposure (UVB) is related to a higher rate of photocarcinogenesis, it has also been shown that UVA rays induce substantial mutations in DNA. and direct toxicity, which leads to the formation of skin cancer.
The use of sunscreen and topical retinoids and periodic monitoring of skin cancer have been recommended for the patient.
The case of McElligott became famous after being published in the New England Medical Journal ( The New England Journal of Medicine ) . The difference between the two halves of her face was so radical that she surprised the dermatologists themselves.
The patient received antisolar treatment, retinoids and periodic examinations to prevent the occurrence of skin cancer. This variety of tumor is not a joke. According to data from the Canadian Association of Dermatologists, of 5,800 cases of melanoma each year, 970 end up being fatal.
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