Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Art & Psychiatry
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Conference Oration
Conference Summary
Continuing Medical Education
Cosmetic Dermatology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
Editor Speaks
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Miscellaneous Letter
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News & Views
Observation Letter
Observation Letters
Original Article
Original Contributions
Pattern of Skin Diseases
Pediatric Dermatology
Pediatric Rounds
Presedential Address
Presidential Address
Presidents Remarks
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Review Article
Review Articles
Revision Corner
Self Assessment Programme
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Study Letter
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapy Letter
View Point
What’s new in Dermatology

Translate this page into:

Original Article
PMID: 17656866

Chronic actinic dermopathy - A clinical study in Ladakh

M PS Sawhney
 Department of Dermatology and STD Command Hospital (SC), Pune - 411 040, India

Correspondence Address:
M PS Sawhney
Department of Dermatology and STD Command Hospital (SC), Pune - 411 040
How to cite this article:
Sawhney M P. Chronic actinic dermopathy - A clinical study in Ladakh. Indian J Dermatol Venereol Leprol 2002;68:38-39
Copyright: (C)2002 Indian Journal of Dermatology, Venereology, and Leprology


A total of 176 highlander Ladakhis staying at Leh (Ladakh) at an altitude of 3445 meters were examined for skin changes on the exposed parts of the body. 111 (63.07%) had pigmentation over forehead, cheeks, nose or chin, 53 (30.11%) had telangiectasia over nose, cheeks or ear lobules, 21 (11.93%) had thickening and furrowing over forehead or lateral aspect of the eyes and only 5 (2.82%) had solar keratosis. Pigmentation and telangiectasia though seen in the first decade of life with prevalence rate seen as 48% and 24% respectively, the maximum prevalence has been seen in the second and third decade (79.22% and 25.97% and 62.96% and 48.15% respectively). Thickening and furrowing is seen most commonly in the fifth and sixth decade, which also leads to decreased prevalence of pigmentation and telangiectasia. Telangiectasia as a skin change to prolonged exposure to short wave length UV radiation has not been described by Eguren in 1972. Dilatation of the blood vessels in the dermis described by him correlates well with our finding of telangiectasia. Thus skin changes of pigmentation, telangiectasia, thickening and furrowing of the sun exposed skin and histopathological changes of Egurer s HA Dermopathy should be included in the syndrome of chronic actinic dermopathy.
Keywords: Chronic actinic dermopathy, High altitude dermopathy


The native highlanders are exposed to prolonged high doses of ultraviolet radiation especially those who work outdoors. They have been reported to develop pigmentation, thickening and furrowing of the skin.[1] Histopathological entity with specific changes in epidermis and dermis called high altitude dermopathy has been described earlier by Eguren.[2] This prompted us to undertake a study of skin changes in highlander Ladakhis staying at an altitude of 3445 meters at Leh (Ladakh).

Materials and Methods

Atotal of 176 highlander Ladakhis were examined for skin changes on the exposed parts of the body.


The mean age of the subjects was 22.28 years (range 3 - 58 years). 125 (71.02%) were males and 51 (28.98%) were females.

A total of 111(63. 07%) of patients had hyperpigmentation over forehead, nose, cheek or chin. Telangiectasia over cheeks, ear lobules or nose was seen in 53 (30.11%). 21(11.93%) had thickening and furrowing over forehead and lateral aspects of eyes. Solar keratosis was seen in only 5(2.82%) of the subjects. Relationship between sex and chronic actinic dermopathy is as shown in [Table - 1].

Relationship between age and these changes is an shown in [Table - 2].

The subjects belonged to various occupations and the relationship between the occupations and these changes is as shown in [Table - 3]. In the miscellaneous group two of them were preschool children, 3 were housewives not involved in farming,one each were clerk, teacher and shopkeeper.


Native highlanders especially peasants engaged for long hours in the field exposed to ultraviolet radiation of shorter wave lengths have been described to develop pigmentation, thickening and furrowing of the skin.[1] Apart from this we also found a high incidence of telangiectasia over the cheeks, nose or ear lobules in highlander Ladakhis. The values of UVB radiation at Leh have been found to be 250% of those found at the sea level at mid noon.[3]

The clinical changes of chronic actinic dermopathy should thus include hyperpigmentation, telangiectasia, thickening and furrowing of the skin exposed to prolonged ultraviolet radiation as is present in high altitude areas. Histopathologically it produces changes as has been described by Eguren as high altitude dermopathy.[2] The presence of dilated blood vessels and lymphatics as described by him correlates well with our finding of telangiectasia. The prevalence of solar keratosis in Ladakhis has been found to be low as compared to some of the Western reports in individuals with fairer complexion.[1],[4] We did not come across any case of skin malignancy.

The skin changes of chronic actinic dermopathy start right in the childhood. Due to chronic sunburn reactions high incidence of hyperpigmentation (48%) and telangiectasia (24%) has been seen even in the first decade in this study. These changes continue to incise during second, third and fourth decades of life. The incidence of telangiectasia reaches its peek in the third decade. Then due to thickening and furrowing of the skin most commonly seen in the fifth and sixth decades incidence of telangiectasia and hyperpigmentation decreases. These changes thus represent the process of acclimatisation of the skin to high doses of short wavelength ultraviolet radiation.

Telangiectasia, thickening and furrowing of the skin have been found to be slightly more common in females. High incidence of hyperpigmentation over face found in students and recruits is because this group is in the first and second decades of life and being exposed to long hours of outdoor playing or training activities. Thickening and furrowing of the skin is more common in peasants.

Heath D, Williams DR. Skin and nails, In High Altitude Medicine and Pathology. 4'h edition, Oxford, New York, 1995: 307 - 316.
[Google Scholar]
Eguren VI. Morfologia histologica de le pie[ expuesta en grades altitudes. Dermatopatio de alture. Unpublished M.D. thesis Universidad National Mayor de San Marcos, Lima, 1972 (as quoted in 1. above).
[Google Scholar]
Basu CK, Goutam RK, Kumar H, et al. Comparative evaluation of biochemical problems at equivalent high altitude areas in the Eastern and Western Himalayas. Project Report No. DIP AS/29/96, Delhi, 1996: 54 - 63.
[Google Scholar]
Sanderson KV, Mackie R. Tumours of the Skin, In Textbook of Dermatology, edited by Rook A, Wilkinson DS, Ebling FJG, 3rd edition, Blackwell Scientific Publications, Oxford, 1979, 2129 - 2231.
[Google Scholar]
Show Sections