Background: Australians have been subjected to high intensity UV through their geographical location and lifestyle habits. UV levels are expected to continue rise, which will contribute to increase skin damage and skin cancer risk. A combination of geographical and cultural factors have contributed to significant cumulative solar UV exposure in adults residing in south-east Queensland.
Aim: To investigate the correlation between the clinical grading of photodamage with histological severity of actinic elastosis in patients with high-risk of melanoma, comparing the grades at 2 photo-exposed sites and 1 photo-protected site as control
Methods: Participant data were reviewed from the Health Outcomes Program clinical study, which recruited individuals with a high risk of melanoma. Subsequent inclusion criteria included a history of at least one Clarke level 2 or greater melanoma on the back, the site of the melanoma was identifiable on a VECTRA 3D avatar of the participant, and whole exosome sequencing was available. Skin biopsies were then taken at three body sites – immediately adjacent to the melanoma scar, nearby skin on the back (approximately 5cm away from the scar), and from the upper gluteal region. Clinical assessment of photodamage was performed by two researchers, and histopathological assessment was conducted by an expert dermatopathologist.
Results: Both the clinical assessment of photodamage and histological grade of actinic elastosis showed a significant difference between the photo-exposed and photo-protected sites. There was a correlation between the clinical and histological severity grades for photodamage and actinic elastosis respectively.
Conclusion: The correlation between the clinical grading of photodamage and the histological severity of actinic elastosis may be helpful for future studies whereby cumulative lifetime UV exposure may be determined histologically without the need for biopsy, which is superior to using self-reported UV exposure questionnaires.