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​Grading of Solar Elastosis Cumulative Sun Damage (CSD)

Grading of Solar Elastosis Cumulative Sun Damage (CSD)

Solar elastosis, a marker of cumulative sun damage (CSD), is graded into three categories: mild (grade 1), moderate (grade 2), and severe (grade 3), based on changes in collagen fibres, which take on an elastotic appearance due to prolonged UV exposure.

 ​It is important to note that there is no clear boundary between these grades, as they gradually transition into each other, and the assessment more qualitative than quantitative.

Why is this important?

 

Mild to moderate CSD

These tumours typically occur in individuals who experience intermittent sun exposure, often at a younger age.

  • Superficial spreading melanoma

  • Basal cell carcinoma, particularly the nodular subtype

 

Severe CSD

In contrast, these cancers are typically seen in individuals who have experienced long-term, chronic sun exposure, particularly in older patients.

  • Lentigo Maligna Melanoma

  • Basal Cell Carcinoma, particularly the superficial subtype

  • Actinic Keratosis

  • Squamous Cell Carcinoma

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Grade 1 

Presence of single, elastotic fibres.

Mild: Characterized by the presence of single collagen fibres with an early elastotic appearance.

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Grade 2 

Clumping of elastotic fibres.

Moderate: Clusters of collagen fibres exhibit slight clumping and a more pronounced elastotic transformation.

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Grade 3 

Basophilic elastotic material that has lost its fibrillary texture.

Severe: Clumped basophilic material replaces the collagen fibres, which have lost their fibrillary texture.

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