# Sun damage after 28 years of driving a delivery truck > A 69-year-old man presented with a history of gradual thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis. ![[28 years trucker sun damage.png]] Source: [The New England Journal of Medicine](https://www.nejm.org/doi/full/10.1056/nejmicm1104059)