Chronic actinic dermatitis describes a chronic persistent photodermatosis marked at the two extremes by:
It affects older males more often. Presentation may be with an itchy, pruritic, indurated, and lichenified eczema involving all exposed areas, with a sharp border where clothing begins. The lesions may be perennial or appear mainly in summer (1).
It may occur after acute photoallergic reactions to topical chemicals or may evolve from a non-specific eczema. Diagnostic skin biopsy reveals a chronic dermatitis. Phototesting and testing for contact and photo-contact allergy are often useful in these patients (1).
Management is based on sun avoidance and allergen avoidance, topical steroids, desensitisation therapy with PUVA, and immunosuppressive agents such as cyclosporin and azathioprine (1).
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