No abstract

Ten elderly male patients with severe persistent photosensitivity of unknown cause are described. The clinical presentation was that of an intense eczematous eruption affecting exposed sites but spreading elsewhere. Frequent episodes of erythroderma were characteristic and in some cases the marked thickening and ridging of the exposed skin simulated a lymphoma. In contrast to most other photodermatoses the photosensitivity extended through the u.v. to the visible spectrum. A wide range of histological changes were noted, in several instances closely resembling lymphoma because of the intensity and pleomorphisni of the infiltrate.OUR purpose is to describe a group of elderly male patients wlio developed chronic ])hotosensitivit3^ which, when the clinical changes were severe, suggested lymphoma. Additional features were the severity and wide spectral range of the photosensitivity and the intense dermal intiltrate whieh often showed a histologieal resemblance to retieulosis.Similar instances of photosensitivity inducing lymphoma-Iike reactions do not seem to have been described in detail previously and are not mentioned among the eommon patterns of ])hotosensitivity reviewed by Kesten and Slatkin (1953). However. Lamb and colleagues (1057) recorded 3 eases of photosensitivity in which the histological intiltrate showed retieular eells, plasma cells and eosinoi)hils and simulated '' lymplioblastoma ". Andrews and Domonkos (1963) also noted a similar instance. Wiskemann (196S) has kindly drawn our attention to 2 patients whom he has studied. Tliey, it seems, bear a elose resemblance to the patients we describe here and bad reticulosis-like reactions provoked by longwave u.v.r. and visible light (Meinhof, 1962; Wiskemann, 19r>5).

SummaryA total of 21 patients suffering from drug-induced rashes from practolol have been seen over the past two years. The clinical manifestations varied, with the morphological appearances of the rash resembling those of eczema, lupus erythematosus, lichen planus, and a highly characteristic toxic erythematous psoriasiform eruption. Persistent ocular damage was a feature in three cases.