Chronic actinic dermatitis: A retrospective analysis of 44 cases referred to an Australian photobiology clinic

Abstract

A retrospective study was performed to analyse the clinical and photobiological features and therapeutic outcomes of 44 patients with chronic actinic dermatitis who were evaluated over an 8.3-year period. The study population comprised 37 men and seven women with a mean age of 62.7 years (range 26-85 years). The most common abnormal phototest results were decreased minimal erythema doses to both UVA and -B (73.8%), and to UVA alone (14.3%). Twenty-six patients (78.8%) had at least one allergic, photoallergic or combined allergic/photoallergic reaction. A total of 139 positive contact or photocontact reactions were recorded (mean 4.2 per patient). Most commonly, treatment consisted of photoprotection, topical corticosteroids and episodic use of systemic agents, in particular azathioprine.

Immunologically Mediated Photodermatoses

“…[32,33] Similar cases were then reported and were given various names, including photosensitive eczema, chronic photosensitivity dermatitis, and actinic reticuloid. [32] Later, a group of investigators suggested that all these photosensitive disorders should be considered as a single syndrome called chronic actinic dermatitis.…”

Fotodermatoses Autoimunes Parte I - Fisiopatologia e Diagnóstico

“…93 O espetro de indução mais frequente encontra-se nos UVB e UVA, resultando numa dose de eritema mínimo diminuída para ambos. 64,94 Na DAC ocorre redução de dose de eritema mínimo pelo menos para uma destas radiações: UVB, UVA e luz visível, de forma isolada ou com uma combinação de sensibilidade a UVB, UVA e luz visível. 55 Na DAC poderão, ainda, estar indicados os testes fotoepicutâneos (photopatch) e testes epicutâneos, visto que os doentes podem estar sensibilizados a alergénios relevantes como as lactonas sesquiterpenos das plantas Compositae, após exposição através de jardinagem ou atividades lúdicas, entre outros alergénios (Fig.…”

Photocontact Dermatitis

“…Physical exam Distribution of lesions in sun-exposed areas Phototests UVA, UVB, visible light, patch, and photo-patch testing Labs ANA panel, porphyrin profile, anti-SSB (La) and anti-SSA (Ro) titers, patch testing to appropriately diluted allergens, photo-patch testing Histopathology Skin biopsy (Yap et al, 2003); often nonspecific (Bolognia et al, 2007) Actinic prurigo Pruritic, papular, or nodular eruption on uncovered skin exposed to light Sun protection, topical corticoids, calcineurin inhibitors (Bolognia et al, 2007) Photoallergic contact dermatitis Eczema-like eruption, lichen planus Sun protection, avoidance of allergic trigger (Bolognia et al, 2007) Porphyria cutanea tarda Increased skin fragility, blistering, erosions, crusts, milia, and scars in sun-exposed areas; uroporphyrinogn decarboxylase mutation (Lebwohl, 2005) Sun protection, avoidance of triggering factors such as alcohol, phlebotomy…”