Pigmentary changes occur In the skin with aging. During adulthood, the number of melanocytes decreases by about 10% to 29% per decade and the development of new melanocytlc nevi also declines. Aging skin becomes more avascular and thus more marked by pallor. Long-term sun exposure produces a number of pigmentary changes, including idiopathic guttate hypomelanosis (which manifests as angular or circular, usually well-circumscribed, white or gray mac-ules) and lentigines (commonly referred to as "liver spots"). The signs of cumulative photodamage Include wrinkling, irregular thinning of the epidermis, blotchy hyperpigmentation, and telangiectasia formation. Drug-induced alterations in pigmentation are probably more common in the elderly because they take more medications than younger adults and they usually have had more protracted exposure to causal medications as a result of prolonged duration of use.
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