{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:57:51Z","timestamp":1781326671068,"version":"3.54.1"},"reference-count":7,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>This report describes a case of 62-year-old monozygotic twin sisters showing markedly different patterns of cutaneous aging despite identical genetics. One twin, affected by long-standing non-segmental vitiligo, exhibited features of hypertrophic photoaging, including pronounced wrinkling and dermal thickening, while the unaffected twin showed an atrophic phenotype with smoother, thinner skin. Imaging findings supported these differences. The case highlights the complex interplay between ultraviolet exposure, genetic factors such as MC1R, and non-genetic influences, suggesting that melanocytic loss and environmental factors contribute significantly to divergent skin aging outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics16121768","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:25:16Z","timestamp":1780935916000},"page":"1768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertrophic Versus Atrophic Photoaging in Monozygotic Twins: Insights from a Unique Vitiligo Case Report"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3795-3190","authenticated-orcid":false,"given":"Ilaria","family":"Proietti","sequence":"first","affiliation":[{"name":"Dermatology Unit \u201cDaniele Innocenzi\u201d, \u201cA. Fiorini\u201d Hospital, 04019 Terracina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8346-8359","authenticated-orcid":false,"given":"Vincenzo","family":"Coppolelli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0811-7601","authenticated-orcid":false,"given":"Alberto","family":"Taliano","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annunziata","family":"Dattola","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-0883","authenticated-orcid":false,"given":"Steven Paul","family":"Nistic\u00f2","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7222-2951","authenticated-orcid":false,"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Potenza","sequence":"additional","affiliation":[{"name":"Dermatology Unit \u201cDaniele Innocenzi\u201d, \u201cA. Fiorini\u201d Hospital, 04019 Terracina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-6694","authenticated-orcid":false,"given":"Stefania","family":"Guida","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hughes, B.K., and Bishop, C.L. (2022). Current Understanding of the Role of Senescent Melanocytes in Skin Ageing. Biomedicines, 10.","DOI":"10.3390\/biomedicines10123111"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jaad.2020.04.075","article-title":"Atrophic and hypertrophic skin photoaging and melanocortin-1 receptor (MC1R): The missing link","volume":"84","author":"Guida","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1002\/path.1538","article-title":"Mechanisms underlying the dysfunction of melanocytes in vitiligo epidermis: Role of SCF\/KIT protein interactions and the downstream effector, MITF-M","volume":"202","author":"Kitamura","year":"2004","journal-title":"J. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1600-0625.2004.00256.x","article-title":"Melanocortins in fibroblast biology\u2013current update and future perspective for dermatology","volume":"13","author":"Luger","year":"2004","journal-title":"Exp. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e16790","DOI":"10.1111\/jocd.16790","article-title":"Emerging Roles of Dermal Fibroblasts in Hyperpigmentation and Hypopigmentation: A Review","volume":"24","author":"Gao","year":"2025","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5954","DOI":"10.2340\/00015555-3708","article-title":"Prevalence of Atrophic and Hypertrophic Skin Ageing Phenotypes: A UK-based Observational Study","volume":"100","author":"Langton","year":"2020","journal-title":"Acta Derm.-Venereol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Musolff, N., Cantisani, C., Guida, S., Michelini, S., Tchack, M., Rao, B., and Pellacani, G. (2024). Different Pathways of Skin Aging: Objective Instrumental Evaluation. Diagnostics, 14.","DOI":"10.3390\/diagnostics14212381"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1768\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:37:40Z","timestamp":1781325460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":7,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["diagnostics16121768"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16121768","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}