Chronic Actinic Dermatitis: A Clinical and Photobiological Study in 6 Japanese Patients

Abstract

Chronic actinic dermatitis (CAD) has distinct clinical features different from polymoφhous light eruption (PLE). In order to clarify the difference between CAD and PLE, not only in clinical histories and findings but also in photobiological and histopathological reactions to phototests, we investigated 6 Japanese patients with CAD and performed provocative phototests which are our standardized methods in diagnosing PLE. On provocative phototests in CAD, pruritic papules were reproduced with smaller doses of UVB, at longer hours after irradiation (48-72 h) and they lasted for more days than in patients with PLE. Our study demonstrated that although milder cases of CAD and severe cases of PLE could not be distinguished clearly based on photobiological reactions alone, typical cases of CAD showed completely different provocative phototest results from those of PLE.

Actinic reticuloid

“…Actinic reticuloid should also be distinguished from photocontact allergy, photosensitive atopic dermatitis, airborne dermatitis, and polymorphic light eruption. The clinical localization, histology, results of patch and photopatch tests, and MED to the ultraviolet spectrum may help to establish the diagnosis .4 , 23 , 51 …”

“…The incidence and prevalence of actinic reticuloid are difficult to establish .2 , 4 Cases have been observed worldwide, with the highest number in northwestern Europe, especially Holland .2 , 21 Large groups of patients have also been observed in the USA and Japan, although they contained the chronic actinic dermatitis spectrum .22 , 23 The most accurate data have come from the Tayside region of Scotland, where the frequency of chronic actinic dermatitis is about 1 : 6000 .5 Chronic actinic dermatitis was described as the second most frequent light‐induced or light‐provoked dermatitis, representing between 11% and 17% of patients with photoreactions .24 , 25…”

“…The unifying concept of chronic actinic dermatitis remains useful despite inherent deficits .7 , 100 Most descriptions of actinic reticuloid report it together with chronic actinic dermatitis .2−4 , 23 , 34 , 64 , 101 It is important to delineate actinic reticuloid, even if it is the last stage of chronic actinic dermatitis, as it demonstrates a distinct clinical and histologic pattern which merits special scrutiny.…”

Polymorphous light eruption and benign summer light eruption in Italy

“…Hawk (10) considers BSLE only a mild form of Anglo-Saxon PLE and maintains that chronic actinic dermatitis (CAD) is the severest form of European PLE, a spectrum he feels includes Anglo-Saxon PLE, actinic prurigo and CAD. Kurumaji et al (11), instead, maintain the existence of CAD as an isolated entity.…”

Severe refractory chronic actinic dermatitis successfully treated with tacrolimus ointment

“…S ir , Chronic actinic dermatitis (CAD) is a persistent, ultraviolet (UV) radiation‐induced eczema of exposed and sometimes also covered sites 1,2 . Numerous therapeutic approaches have been tried for CAD including systemic corticosteroids and immunosuppressants, but there remain many refractory cases.…”