Case history
Case history #1
A 45-year-old woman presents with moderate wrinkles on the face. She has a type II skin type according to the Fitzpatrick classification and has smoked 10 to 15 cigarettes per day for 25 years. Due to her profession as a sports instructor, she is exposed to the sun throughout the year and reports that she is not careful about using high-factor sunscreens. On clinical examination, moderate frown lines across the forehead are present at rest. Superficial lines are appearing on the lateral canthal areas and around the mouth, which become more marked on animation. Nasolabial folds are obvious at rest, and superficial wrinkling on the neck and the cheeks is evident on smiling. Moderate sagging of the skin is recorded. Small solar keratoses are appearing over the dorsum of the hands.
Case history #2
An 82-year-old man presents with severe wrinkles on the face and neck. He has a type III skin type according to the Fitzpatrick classification. He is a retired police officer, and is fit and well. On clinical examination, severe frown lines across the forehead are present at rest. Advanced lines are appearing on the lateral canthal areas and around the mouth, which become more marked on animation. Nasolabial folds are deep, even at rest, and sparseness of cheek fat with skin laxity, as well as multiple moderate wrinkles, are observed. Numerous solar keratoses are appearing over the cheeks. There is advanced laxity of the skin and deep wrinkles across the neck.
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