Association of Leucocyte Telomere Length With Clinical Examination and Dermoscopic Photoaging Scale (DPAS) Score in Skin Aging: a Pilot Study

Skin aging is a process of deterioration in the physiological structure and function of the skin that significantly increases in the 4th and 5th decades of life. Skin aging is a combination of physiological and pathological aging. Physiological change cannot be avoided and mandatory for everyone, pathological aging ir extrinsic aging is an abnormal skin condition caused by cigarettes, pollution and ultraviolet (UV). In general, the clinical characteristics of skin aging consist of pigmentation changes, hydration disorders, the appearance of wrinkles and skin tumors. The photoaging assessment was first proposed in 1996 by Dr. Richard Glogau, The Glogau scale assesses photoaging based on clinical assessment grouped into 4 categories, namely types I, II, III, and IV,where each type is graded by the severity of wrinkles, namely from mild, moderate, advanced, and severe. Isik et al. developed an instrument for quantitative skin aging assessment using dermoscopy. This examination is non-invasive and is expected to provide a more objective assessment. There are four facial regions assessed in the DPAS score calculation: forehead, right cheek, left cheek, and chin. The sum of the scores of the four regions is assessed based on 11 parameters, with a maximum final score of 44. Telomeres are repetitive DNA-Protein complexes located at the ends of chromosomes of eukarotic cells, and their function is to maintain chromosome stability during cell division, by protecting chromosomes from degradation and fusion. Many factors affect telomere length, such as body mass index, hormonal therapy, antioxidant intake, chronic diseases, and gender. Research by son et al. found that telomere length shortening was validated to increase the odds of skin aging (OR=0.96, 95% CI: 0.9332-0.99566, P= 0.03) Telomeres are closely linked to cellular aging, especially in dermal cells and telomere shortening in skin fibroblasts may lead to epidermal aging and barrier function defectcs.