Chronic actinic dermatitis: A 5‐year clinical analysis of 488 patients in China

Gu, Qiaozhi; Zhang, Zhen; Yang, Jin; Gao, Haiqing; Y, Hu; Xu, Yu; Ren, Jie; Luo, Xiaoqun; Ma, Li

doi:10.1111/phpp.12835

Cited by 6 publications

(8 citation statements)

References 23 publications

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“…1 This reaction induces inflammation of skin areas exposed to sunlight leading to a pruritic rash or eczema and, in the long term, to scaling and lichenification. 2 In severe cases the reaction could be elicited with minimum exposure to light, heavily impacting quality of life in our patients. It is not rare to find it in the context of other dermatoses such as atopic dermatitis, photocontact 3 or contact allergic dermatitis (fragrances, airborne particles, and plants like chrysanthemum…).…”

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confidence: 66%

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Successful treatment of chronic actinic dermatitis with alitretinoin: Should retinoids be included in the therapeutical arsenal?

Prados-Carmona

Ruiz‐Villaverde

Aranda

et al. 2023

Photoderm Photoimm Photomed

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Chronic actinic dermatitis (CAD) is an infrequent and underdiagnosed photodermatosis mostly reported in adult men. There are still unmet therapeutic needs regarding this condition, forcing us to look for off-label alternatives.A 62-year-old construction worker came to our Contact Eczema and Immunoallergic Department with severe hyperkeratotic plaques in sun-exposed areas. He had been suffering from chronic lesions on the dorsal side of his hands, knees, elbows, and upper back for 12 years that had progressively become lichenified (Figure 1). The

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confidence: 66%

“…Nevertheless, it has recently been published that up to 18.2% of 488 patients show UVA reactivity exclusively. 2 Its treatment is nothing short of challenging. 4 Apart from sun avoidance measures, systemic immunosuppression is usually required.…”

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confidence: 99%

Successful treatment of chronic actinic dermatitis with alitretinoin: Should retinoids be included in the therapeutical arsenal?

Prados-Carmona

Ruiz‐Villaverde

Aranda

et al. 2023

Photoderm Photoimm Photomed

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“… 9 , 10 It is believed that the recognition of UV-induced neoantigens by lymphocytes in the skin may underlie this process. 7 While CAD affects individuals of any sex and age, it primarily develops in men over 50 years of age, 11 , 12 particularly those with fair skin, 13 often engaging in outdoor activities. 10 These sex and age patterns appear to be more pronounced in Asian populations.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Chronic Actinic Dermatitis with Tofacitinib

Zhong,

Ali,

Yang

et al. 2024

CCID

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We present the case of a 58-year-old male patient who presented with pruritic skin plaques and papules on the scalp, face, back, and back of the hands for over a year. The symptoms worsened upon exposure to sunlight and improved on cloudy days. Despite previous attempts at treatment with glucocorticoid ointment and antihistamine drugs, the patient experienced progressive aggravation of symptoms. Physical examination revealed hypertrophic and infiltrating nodules, with significant scratches and local exudation. Skin biopsy confirmed the diagnosis of sun-induced dermatosis. The patient was initiated on tofacitinib, an oral Janus Kinase inhibitor, along with a halometasone ointment, oral ebastine tablets, and strict sun protection. Over the course of four revisits spanning four months, the patient experienced a significant improvement in symptoms, with the rash almost disappearing and pruritus subsiding. The treatment was well tolerated and no adverse effects were observed. Follow-up for six months post-treatment showed no recurrence of symptoms. This case highlights the efficacy of tofacitinib in managing sun-induced pruritic plaques and suggests it as a potential therapeutic option in similar cases.

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“…It is associated with long-term ultraviolet radiation (UVR) exposure and photosensitivity. 1 Typical skin lesions include erythema, papules, and plaques in sun-exposed regions of the skin. In severe cases, these lesions can extend throughout the whole body, accompanied by severe itching, leading to a significant deterioration in quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic actinic dermatitis (CAD) is an immune‐mediated photodermatosis predominantly affecting men over the age of 50. It is associated with long‐term ultraviolet radiation (UVR) exposure and photosensitivity 1 . Typical skin lesions include erythema, papules, and plaques in sun‐exposed regions of the skin.…”

Section: Introductionmentioning

confidence: 99%

Role of interleukin‐36γ induced by ultraviolet radiation in chronic actinic dermatitis

Wang,

Tu,

et al. 2023

Photoderm Photoimm Photomed

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BackgroundChronic actinic dermatitis (CAD) is an immune‐mediated photodermatosis characterized by a high eosinophil count and total immunoglobulin E (IgE) in the peripheral blood of patients. At present, however, the reasons for their elevation remain unclear.ObjectiveThe current study aimed to detect changes in inflammatory cytokines in CAD and explore their role in this disease.MethodsEnzyme‐linked immunosorbent assay and Luminex assay were conducted to measure inflammatory factor levels. Immunohistochemical analysis and quantitative real‐time polymerase chain reaction were performed to evaluate the expression levels of interleukin‐36γ (IL‐36γ), IL‐8, chemokine (C‐C motif) ligand 17 (CCL17), and CCL18. CCK8 kits were used to assess cell proliferation. Immunofluorescence was used to detect nuclear factor κB (NF‐κB) p65 nuclear translocation. Western blot analysis was performed to detect the protein expression level of phosphorylated NF‐κB (p‐NF‐κB) p65. Hematoxylin and eosin and Masson trichrome staining were applied to observe histological changes in a chronic photo‐damaged mouse model.ResultsEosinophils, total IgE, IL‐36γ, IL‐8, tumor necrosis factor α, CCL17, and CCL18 were elevated in CAD. Of note, IL‐36γ promoted the proliferation of eosinophilic cells (EOL‐1) and the production of IgE in peripheral blood mononuclear cells. IL‐36γ also promoted the production of IL‐8 and CCL18 in immortalized human keratinocytes (HaCaT cells), while ultraviolet radiation (UVR)‐induced IL‐36γ via activation of the NF‐κB signaling pathway.ConclusionsIL‐36γ was involved in the pathogenesis of CAD and UVR contributed to the production of IL‐36γ, which may provide a novel therapeutic target for CAD.

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Chronic actinic dermatitis: A 5‐year clinical analysis of 488 patients in China

Abstract: Background/Purpose: Chronic actinic dermatitis (CAD) is a spectrum of diseases with chronic photosensitivity occurring mostly among middle-aged and older men.We seek to explore the characteristics and pathogenesis of CAD among the Chinese population.

Cited by 6 publications

References 23 publications

Successful treatment of chronic actinic dermatitis with alitretinoin: Should retinoids be included in the therapeutical arsenal?

Successful treatment of chronic actinic dermatitis with alitretinoin: Should retinoids be included in the therapeutical arsenal?

Successful Treatment of Chronic Actinic Dermatitis with Tofacitinib

Role of interleukin‐36γ induced by ultraviolet radiation in chronic actinic dermatitis

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