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Chronic Actinic Dermatitis

Actinic Reticuloid


Presentation

Pathologist
  • For the pathologist, the differential diagnosis is with a cutaneous lymphoma since there is often a dense lymphoid infiltrate.[thedoctorsdoctor.com]
Proximal Muscle Weakness
  • Proximal muscle weakness and bony tenderness resulting from the disorder resolved on vitamin D replacement therapy.[ncbi.nlm.nih.gov]
Muscle Weakness
  • Proximal muscle weakness and bony tenderness resulting from the disorder resolved on vitamin D replacement therapy.[ncbi.nlm.nih.gov]
Eczema
  • The clinical patterns varied from patients presenting with generalized eczema (20%) or eczema of the hands and face (24%), to patients with hand (36%) or facial eczema (11%) alone. 48 patients were investigated for suspected photosensitivity and 29 (21[ncbi.nlm.nih.gov]
Pruritus
  • Tacrolimus ointment led to significant improvement of pruritus and severe eczematous skin lesions after 20 days of treatment.[ncbi.nlm.nih.gov]
  • There was disappearance of pruritus, erythema, scaling and infiltration in spite of exposure to sunlight and tapering off of steroids.[e-ijd.org]
  • 199 Pruritus Ani 200 Pruritus Vulvae 201 Pseudofolliculitis Barbae 202 Pseudoxanthoma Elasticum 203 Psoriasis 204 Psychogenic Excoriation 205 Pyoderma Gangrenosum 206 Pyogenic Granulomas 207 Radiation Dermatitis 208 Raynaud's Disease and Phenomenon 209[elsevier.com]
  • Pruritus and cutaneous inflammatory conditions in HIV disease. Clin Dermatol. 2000;18(4):479–484. (99)00143-1 Vin-Christian K, Epstein JH, Maurer TA, McCalmont TH, Berger TG. Photosensitivity in HIV-infected individuals.[sajhivmed.org.za]
  • Pruritus is not usual. Desquamation and hyperpigmentation can occur. Usually self-limiting. Management [ 26 ] Avoidance of plants/sunlight.[patient.info]
Chronic Dermatitis
  • Multiple cutaneous allergens may be identified in patients with chronic actinic dermatoses, and avoidance of known allergens may result in significant improvement of the chronic dermatitis.[ncbi.nlm.nih.gov]
  • The basic components of this disease are a persistent, chronic, eczematous eruption in the absence of exposure to known photosensitizers; photosensitivity to UVA, and/or UVB, and/or visible light; and histology consistent with a chronic dermatitis with[scopemed.org]
  • dermatitis (sometimes with pseudoreticuloid features) predominantly of photo-exposed sites.[clinicalgate.com]
  • dermatitis with thick plaques on sun-exposed areas Images Please click on images to enlarge or download.[pcds.org.uk]
Suggestibility
  • Therefore, it is suggested that tacrolimus may prevent UV-B induced erythema by suppressing a very early phase of the inflammatory process in CAD.[ncbi.nlm.nih.gov]
Withdrawn
  • RESULTS: Among all the 40 patients, two (5%) were clinically cured and 23 (57.5%) achieved excellent results, making a total effective rate of 62.5%; 14 (35%) were improved; and one (2.5%) case was withdrawn due to intolerable itching at the locally applied[ncbi.nlm.nih.gov]
  • The halogenated salicylanilides, which were responsible chiefly for photoallergic dermatitis more than two decades ago, have been withdrawn from the market as agents to be employed against bacteria topically.[derm101.com]

Workup

  • The aim of this report is to show the spectrum of presentations of patients with CAD and to outline the proper diagnostic workup of these individuals.[ncbi.nlm.nih.gov]
  • Journal of the American Academy of Dermatology. 2009; 60(3): 359-375 [Pubmed] 12 Chronic actinic dermatitis: Clinical cases, diagnostic workup, and therapeutic management Beach, R.A., Pratt, M.D.[ijdvl.com]
  • Chronic actinic dermatitis: clinical cases, diagnostic workup, and therapeutic management. J Cutan Med Surg 2009;13:121–128. 10. Bakels V, van Oostveen JW, Preesman AH, Meijer CJ, Willemze R.[synapse.koreamed.org]
  • S.M. 2009 35 Case report of four patients with erythrodermic cutaneous T-cell lymphoma and severe photosensitivity mimicking chronic actinic dermatitis. ( 19067712 ) Agar N....Whittaker S. 2009 36 Chronic actinic dermatitis: clinical cases, diagnostic workup[malacards.org]

Treatment

  • PATIENT AND TREATMENT: A 58-year-old man with CAD, resistant to previous treatment with topical and systemic corticosteroids, oral cyclosporine and PUVA-photochemotherapy, was treated with tacrolimus ointment 0.1% once a day.[ncbi.nlm.nih.gov]

Prognosis

  • Loss of contact allergies was not associated with a different prognosis for photosensitivity resolution.[ncbi.nlm.nih.gov]
  • Created: 10th October 2011 Last Updated: 13th January 2019 Introduction Aetiology Aetiology unknown It is mainly found in older men but can arise in younger, atopic patients (the prognosis in this latter group is better) History Itch and erythema are[pcds.org.uk]
  • The etiology is currently unknown, and the prognosis is unpredictable with some individuals experiencing spontaneous remission [ 1, 7 ]. Diagnosis can be made by phototesting, patch testing, and biopsy [ 7 ].[omicsonline.org]
  • The prognosis for the associated contact allergic dermatitis is even worse, with some predicting chronic actinic dermatitis.[dermatitisfacts.com]

Etiology

  • BACKGROUND: Chronic actinic dermatitis (CAD) is a recurrent photosensitive dermatitis that occurs predominantly on sun-exposed areas with unknown etiology.[ncbi.nlm.nih.gov]
  • A variety of etiologies such as photoallergic, phototoxic, immunologic and metabolic factors have been postulated in CAD. It is initiated and clinically triggered with exposure to sunlight and artificial radiation.[scopemed.org]
  • ., an itchy, inflammatory skin disorder caused due to sun exposure persisting for long term. 2 3. 3 ETIOLOGY: Action Spectrum- UVA, UVB, Visible light.[slideshare.net]
  • […] a Phototherapy Referral Center or an OfficeBased Phototherapy Unit 449 Guidelines for Setting Up a Laser Center 457 Index 463 Back cover 473 حقوق النشر مقاطع مشهورة الصفحة 117 - Harris, CC Mutations in the p53 tumor suppressor gene: clues to cancer etiology[books.google.com]
  • The etiology is currently unknown, and the prognosis is unpredictable with some individuals experiencing spontaneous remission [ 1, 7 ]. Diagnosis can be made by phototesting, patch testing, and biopsy [ 7 ].[omicsonline.org]

Epidemiology

  • BACKGROUND: Chronic actinic dermatitis is a photosensitivity disorder with scant epidemiologic data. Case series in Europe have previously shown that improvement or resolution of chronic actinic dermatitis occurs over time in most patients.[ncbi.nlm.nih.gov]
  • ULTRAVIOLET AND VISIBLE RADIATION THERAPY 319 Chapter 23 UltravioletA1 and Visible Light Therapy 335 Chapter 24 Psoralen Photochemotherapy 347 Chapter 25 Extracorporeal Photochemotherapy Photopheresis 359 Chapter 26 Photodynamic Therapy 369 Chapter 9 The Epidemiology[books.google.com]
  • Pellagra: A clinical, histopathological, and epidemiological study of 7 cases. Actas Dermosifiliogr. 2012;103(1):51–58. Murray MF, Langan M, MacGregor RR.[sajhivmed.org.za]
  • OUTLINE EPIDEMIOLOGY CHARACTERIZATION SYNONYMS Chronic actinic dermatitis Persistent light reaction INCIDENCE/ PREVALENCE AGE SEX GEOGRAPHY IRELAND Photosensitivity dermatitis/actinic reticuloid syndrome in an Irish population: a review and some unusual[thedoctorsdoctor.com]
Sex distribution
Age distribution

Prevention

  • Therefore, it is suggested that tacrolimus may prevent UV-B induced erythema by suppressing a very early phase of the inflammatory process in CAD.[ncbi.nlm.nih.gov]
  • He cares for patients with routine skin conditions and specializes in the diagnosis, treatment, and prevention of skin cancers, especially melanoma.[books.google.com]
  • Photoprotection advice should include environmental measures (use of window film to prevent UVA transmission and avoidance of single envelope compact fluorescent lamps for those with extreme UVA and visible light sensitivity), behavioral measures (including[clinicalgate.com]

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