Chronic actinic dermatitis (CAD) is a rare photosensitivity disorder with scant epidemiologic data.
Objective:
To evaluate demographic data and results of photopatch and patch tests over a 25-year period.
Methods:
Retrospective chart review of patients with CAD from 1993 to 2009.
Results:
Forty patients had a mean age of 57.8 years, and 27 (67.5%) were men. Twelve patients (30%) were skin types I and II, and 17 (42.5%) were skin types V and VI. Nine patients (22.5%) were younger than 50 years, and 4 of these (44.4%) were men. One of the nine patients (11.1%) was skin type I, and 4 (44.4%) were skin types V and VI. Carba mix and para-phenylenediamine were the two most commonly positive agents in patch tests. Sunscreens and plants and plant derivatives were the most commonly positive agents in photopatch tests.
Conclusions:
Our findings suggest a trend of two new classes of North American patients at our institution being diagnosed with CAD—younger women with skin types IV to VI and older men with skin types I to III. We observed a greater-than-expected number of positive patch-test reactions to para-phenylenediamine. We suggest that patch testing and photopatch testing of individuals may be useful adjuncts in the assessment of CAD.
Get full access to this article
View all access options for this article.
References
1.
LimHW, MorisonWL, KamideR, et al.Chronic actinic dermatitis: an analysis of 51 patients evaluated in the United States and Japan. Arch Dermatol, 1994; 130:1284-9, doi:10.1001/archderm.130.10.1284.
2.
RussellSC, DaweRS, CollinsP, et al.The photosensitivity dermatitis and actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients. Br J Dermatol, 1998; 138:496-501, doi:10.1046/j.1365-2133.1998.02132.x.
3.
OgboliMI, RhodesLE. Chronic actinic dermatitis in young atopic dermatitis sufferers. Br J Dermatol, 2000; 142:845, doi:10.1046/j.1365-2133.2000.03457.x.
4.
DaweRS, FergusonJ. Diagnosis and treatment of chronic actinic dermatitis. Dermatol Ther, 2003; 16:45-51, doi:10.1046/j.1529-8019.2003.01607.x.
5.
VictorF, CohenD, SoterN. A 20-year analysis of previous and emerging allergens that elicit photoallergic contact dermatitis. J Am Acad Dermatol, 2010; 62:605-10, doi:10.1016/j.jaad.2009.06.084.
ZugKA, WarshawEM, FowlerJFJr, et al.Patch-test results of the North American Contact Dermatitis Group, 2005-2006. Dermatitis, 2009; 20:149-60.
8.
ChewA, BashirS, HawkJ, et al.Contact and photocontact sensitization in chronic actinic dermatitis: a changing picture. Contact Dermatitis, 2010; 62:42-6, doi:10.1111/j.1600-0536.2009.01658.x.
9.
PappertA, GrossmanM, DeLeoV. Photosensitivity as the presenting illness in four patients with human immunodeficiency viral infection. Arch Dermatol, 1994; 130:618-23, doi:10.1001/archderm.130.5.618.
10.
MeolaT, SanchezM, LimHW, et al.Chronic actinic dermatitis associated with human immunodeficiency virus infection. Br J Dermatol, 1997; 137:431-6, doi:10.1111/j.1365-2133.1997.tb03753.x.
11.
WongSN, KhooLS. Chronic actinic dermatitis as the presenting feature of HIV infection in three Chinese males. Clin Exp Dermatol, 2003; 28:265-8.
12.
MenagéH, RossJS, NorrisPG, et al.Contact and photocontact sensitization in chronic actinic dermatitis: sesquiterpene lactone mix is an important allergen. Br J Dermatol, 1995; 132:543-7, doi:10.1111/j.1365-2133.1995.tb08708.x.
13.
KurumajiY, MiyamotoC, FukuroS. Chronic actinic dermatitis: a clinical and photobiological study in 6 Japanese patients. Dermatology, 1994; 189:241-7, doi:10.1159/000246846.
14.
LimHW, CohenD, SoterNA. Chronic actinic dermatitis: results of patch and photopatch tests with Compositae, fragrances, and pesticides. J Am Acad Dermatol, 1998; 38:108-11, doi:10.1016/S0190-9622(98)70549-3.
15.
YounM, ChangJH, ChangSN, et al.A clinical analysis of 11 patients with chronic actinic dermatitis in Korea. Yonsei Med J, 2000; 41:190-4.
16.
SomaniVK. Chronic actinic dermatitis—a study of clinical features. Indian J Dermatol Venereol Leprol, 2005; 71:409-13, doi:10.4103/0378-6323.18946.
17.
BeachRA, PrattMD. Chronic actinic dermatitis: clinical cases, diagnostic workup, and therapeutic management. J Cutan Med Surg, 2009; 13:121-8.
18.
Kyu-WonC, Chae-YoungL, Yeong-KyuL, et al.A Korean experience with chronic actinic dermatitis during an 18-year period: meteorological and photoimmunological aspects. Photodermatol Photoimmunol Photomed, 2009; 25.6:286-92, doi:10.1111/j.1600-0781.2009.00464.x.
19.
YapL, FoleyP, CrouchR, et al.Chronic actinic dermatitis: a retrospective analysis of 44 cases referred to an Australian photobiology clinic. Australas J Dermatol, 2003; 44:256-62, doi:10.1046/j.1440-0960.2003.00004.x.
20.
SostedH, RastogiS, AndersenK, et al.Hair dye contact allergy: quantitative exposure assessment of selected products and clinical cases. Contact Dermatitis, 2004; 50:344-8, doi:10.1111/j.0105-1873.2004.00362.x.
21.
DeleoVA, TaylorSC, BelsitoDV, et al.The effect of race and ethnicity on patch test results. J Am Acad Dermatol, 2002; 46:S107-12, doi:10.1067/mjd.2002.120792.
