The Sunbed Suntan SacroScapular Sparing Sign

Prof. Dr. C.M.E. Rowland Payne, Kent and Canterbury Hospital, Ethelbert Road, Canterbury CT1 3NG, Kent (UK) Sunbed users can frequently be identified by an easily recognised physical sign. Every few weeks, in my clinical practice, I encounter young women who are tanned distinctively. Examination of their dorsal surface often reveals a uniform tan with the exception of a palm-sized macule of un-tanned skin overlying the sacrum and two smaller symmetrical untanned areas overlying the scapulae – the ‘sunbed suntan sacro-scapular sparing sign’. These patients can, by this physical sign, be recognised ‘d’un coup d’æiΓ as sunbed users and probably abusers. All of these patients, who are usually women aged between 18 and 35 years, have been using sunbeds, usually commercially. These sunbeds irradiate the anterior and posterior aspects of the body simultaneously. The patient completely undresses and lies on her back on a sturdy transparent surface. The ultraviolet radiation passes through this material and tans the back uniformly except at the points of maximum weight bearing where the skin is blanched by the vitropression of lying on the hard transparent surface. Blanched areas do not develop the usual delayed tan after exposure to UVA light [1] as UVA-delayed pigmentation is an oxygen-dependent effect [2]. Recognition of this physical sign alerts the physician to the possibility of other more serious actinic damage and prompts a discussion of the hazards of long-term sunbed abuse. References Tegner E, Rorsman H, Rosengren E: 5-S-cysteinyldopa and pigment response to UVA light. Acta Derm Venereol (Stockh) 1983;63: 21-25. Auletta M, Gange RW, Tan OT, Matzinger EA: The differential effect of cutaneous blood flow upon the induction of UVA and UVB pigment responses in human skin. J Invest Dermatol 1984:82:420.