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Focal Photodamage on the Occipital Scalp

Howa Yeung, MD1; Kevin Man-Hin Luk, BS1; Suephy C. Chen, MD, MS1,2
[+] Author Affiliations
1Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
2Division of Dermatology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
JAMA Dermatol. 2016;152(9):1060-1062. doi:10.1001/jamadermatol.2016.0733.
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This case report describes a patient who experienced focal chronic photodamage and actinic keratoses on his scalp despite wearing a baseball cap for scalp sun protection.

Baseball caps are commonly worn in the United States, in part for photoprotection. Public health efforts to prevent skin cancers recommend wide-brimmed hats over baseball caps owing to caps’ incomplete coverage for face, neck, and ears; however, to our knowledge, their relative efficacy for scalp photoprotection has not been investigated. We report a case of focal chronic photodamage and actinic keratoses on a patient’s alopecic scalp despite his adherence to baseball cap use for photoprotection.

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Figure 1.
Semicircular Poikilodermatous Patch and Erythematous Scaly Papules on the Occipital Scalp

A, Focal actinic damage and actinic keratoses on the occipital scalp. B, Snapback hat worn by patient with window of solar exposure.

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Figure 2.
Illustrations of Baseball Cap Style Variations

A, Fitted cap (left) with complete scalp coverage (right). B, Snapback hat (left) with window of occipital exposure (right). C, Trucker hat (left) with mesh covering (right).

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