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Published in: Drugs & Aging 3/2005

01-03-2005 | Therapy In Practice

Chronic Actinic Dermatitis in the Elderly

Recognition and Treatment

Author: Dr Robert S. Dawe

Published in: Drugs & Aging | Issue 3/2005

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Abstract

Chronic actinic dermatitis is a condition involving abnormal cutaneous photosensitivity to UV and, often, visible wavelengths. It is rare, but more common in the elderly than in younger populations, with an estimated prevalence of one in 2000 in the ≥75-year-old population in Tayside, Dundee, Scotland. It usually presents as a dermatitis that maximally, but not exclusively, affects photo-exposed skin. Investigation to confirm the diagnosis and guide management includes phototesting and patch testing. The mainstay of treatment is education about the condition and advice on sunlight and allergen avoidance. Topical corticosteroids and emollients are always required, at least intermittently, and it is sometimes necessary to resort to systemic immunosuppression, usually with corticosteroids or azathioprine.
Literature
1.
go back to reference Frain-Bell W, Lakshmipathi T, Rogers J, et al. The syndrome of chronic photosensitivity dermatitis and actinic reticuloid. Br J Dermatol 1974; 91: 617–34PubMedCrossRef Frain-Bell W, Lakshmipathi T, Rogers J, et al. The syndrome of chronic photosensitivity dermatitis and actinic reticuloid. Br J Dermatol 1974; 91: 617–34PubMedCrossRef
2.
go back to reference Ramsay CA, Black AK. Photosensitive eczema. Trans St Johns Hosp Dermatol Soc 1973; 59: 152–8PubMed Ramsay CA, Black AK. Photosensitive eczema. Trans St Johns Hosp Dermatol Soc 1973; 59: 152–8PubMed
3.
go back to reference Ive FA, Magnus IA, Warin RP, et al. ‘Actinic reticuloid’: a chronic dermatosis associated with severe photosensitivity and the histological resemblance to lymphoma. Br J Dermatol 1969; 81: 469–85PubMedCrossRef Ive FA, Magnus IA, Warin RP, et al. ‘Actinic reticuloid’: a chronic dermatosis associated with severe photosensitivity and the histological resemblance to lymphoma. Br J Dermatol 1969; 81: 469–85PubMedCrossRef
4.
go back to reference Hawk JL, Magnus IA. Chronic actinic dermatitis: an idiopathic photosensitivity syndrome including actinic reticuloid and photosensitive eczema [proceedings]. Br J Dermatol 1979; 101Suppl. 17: 24PubMed Hawk JL, Magnus IA. Chronic actinic dermatitis: an idiopathic photosensitivity syndrome including actinic reticuloid and photosensitive eczema [proceedings]. Br J Dermatol 1979; 101Suppl. 17: 24PubMed
5.
go back to reference Norris PG, Hawk JL. Chronic actinic dermatitis: a unifying concept. Arch Dermatol 1990; 126: 376–8PubMedCrossRef Norris PG, Hawk JL. Chronic actinic dermatitis: a unifying concept. Arch Dermatol 1990; 126: 376–8PubMedCrossRef
6.
go back to reference Toonstra J, Henquet CJ, van Weelden H, et al. Actinic reticuloid: a clinical photobiologic, histopathologic, and follow-up study of 16 patients. J Am Acad Dermatol 1989; 21: 205–14PubMedCrossRef Toonstra J, Henquet CJ, van Weelden H, et al. Actinic reticuloid: a clinical photobiologic, histopathologic, and follow-up study of 16 patients. J Am Acad Dermatol 1989; 21: 205–14PubMedCrossRef
9.
go back to reference Lim HW, Buchness MR, Ashinoff R, et al. Chronic actinic dermatitis: study of the spectrum of chronic photosensitivity in 12 patients. Arch Dermatol 1990; 126: 317–23PubMedCrossRef Lim HW, Buchness MR, Ashinoff R, et al. Chronic actinic dermatitis: study of the spectrum of chronic photosensitivity in 12 patients. Arch Dermatol 1990; 126: 317–23PubMedCrossRef
10.
go back to reference Khoo SW, Tay YK, Tham SN. Photodermatoses in a Singapore skin referral centre. Clin Exp Dermatol 1996; 21: 263–8PubMedCrossRef Khoo SW, Tay YK, Tham SN. Photodermatoses in a Singapore skin referral centre. Clin Exp Dermatol 1996; 21: 263–8PubMedCrossRef
11.
go back to reference Kurumaji Y, Kondo S, Fukuro S, et al. Chronic actinic dermatitis in a young patient with atopic dermatitis. J Am Acad Dermatol 1994; 31: 667–9PubMedCrossRef Kurumaji Y, Kondo S, Fukuro S, et al. Chronic actinic dermatitis in a young patient with atopic dermatitis. J Am Acad Dermatol 1994; 31: 667–9PubMedCrossRef
12.
go back to reference Russell SC, Dawe RS, Collins P, et al. The photosensitivity dermatitis and actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients. Br J Dermatol 1998; 138: 496–501PubMedCrossRef Russell SC, Dawe RS, Collins P, et al. The photosensitivity dermatitis and actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients. Br J Dermatol 1998; 138: 496–501PubMedCrossRef
13.
go back to reference Creamer D, McGregor JM, Hawk JL. Chronic actinic dermatitis occurring in young patients with atopic dermatitis. Br J Dermatol 1998; 139: 1112–3PubMedCrossRef Creamer D, McGregor JM, Hawk JL. Chronic actinic dermatitis occurring in young patients with atopic dermatitis. Br J Dermatol 1998; 139: 1112–3PubMedCrossRef
14.
go back to reference Ogboli MI, Rhodes LE. Chronic actinic dermatitis in young atopic dermatitis sufferers. Br J Dermatol 2000; 142: 845PubMedCrossRef Ogboli MI, Rhodes LE. Chronic actinic dermatitis in young atopic dermatitis sufferers. Br J Dermatol 2000; 142: 845PubMedCrossRef
15.
go back to reference Willis I, Kligman AM. The mechanism of the persistent light reactor. J Invest Dermatol 1968; 51: 385–94PubMed Willis I, Kligman AM. The mechanism of the persistent light reactor. J Invest Dermatol 1968; 51: 385–94PubMed
16.
go back to reference Addo HA, Sharma SC, Ferguson J, et al. A study of compositae plant extract reactions in photosensitivity dermatitis. Photodermatol 1985; 2: 68–79PubMed Addo HA, Sharma SC, Ferguson J, et al. A study of compositae plant extract reactions in photosensitivity dermatitis. Photodermatol 1985; 2: 68–79PubMed
17.
go back to reference Frain-Bell W. Photosensitivity dermatitis and actinic reticuloid syndrome: cutaneous photobiology. Oxford: Oxford University Press, 1985: 106–24 Frain-Bell W. Photosensitivity dermatitis and actinic reticuloid syndrome: cutaneous photobiology. Oxford: Oxford University Press, 1985: 106–24
18.
go back to reference Menage H, Ross JS, Norris PG, et al. Contact and photocontact sensitization in chronic actinic dermatitis: sesquiterpene lactone mix is an important allergen. Br J Dermatol 1995; 132: 543–7PubMedCrossRef Menage H, Ross JS, Norris PG, et al. Contact and photocontact sensitization in chronic actinic dermatitis: sesquiterpene lactone mix is an important allergen. Br J Dermatol 1995; 132: 543–7PubMedCrossRef
19.
go back to reference Frain-Bell W, Hetherington A, Johnson BE. Contact allergic sensitivity to chrysanthemum and the photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1979; 101: 491–501PubMedCrossRef Frain-Bell W, Hetherington A, Johnson BE. Contact allergic sensitivity to chrysanthemum and the photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1979; 101: 491–501PubMedCrossRef
20.
go back to reference Frain-Bell W, Johnson BE. Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1979; 101: 503–12PubMedCrossRef Frain-Bell W, Johnson BE. Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1979; 101: 503–12PubMedCrossRef
21.
go back to reference Dawe RS, Crombie IK, Ferguson J. The natural history of chronic actinic dermatitis. Arch Dermatol 2000; 136: 1215–20PubMedCrossRef Dawe RS, Crombie IK, Ferguson J. The natural history of chronic actinic dermatitis. Arch Dermatol 2000; 136: 1215–20PubMedCrossRef
22.
go back to reference Addo HA, Frain-Bell W. Persistence of allergic contact sensitivity in subjects with photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1987; 117: 555–9PubMedCrossRef Addo HA, Frain-Bell W. Persistence of allergic contact sensitivity in subjects with photosensitivity dermatitis and actinic reticuloid syndrome. Br J Dermatol 1987; 117: 555–9PubMedCrossRef
23.
24.
go back to reference Ashinoff R, Buchness MR, Lim HW. Lymphoma in a black patient with actinic reticuloid treated with PUVA: possible etiologic considerations. J Am Acad Dermatol 1989; 21: 1134–7PubMedCrossRef Ashinoff R, Buchness MR, Lim HW. Lymphoma in a black patient with actinic reticuloid treated with PUVA: possible etiologic considerations. J Am Acad Dermatol 1989; 21: 1134–7PubMedCrossRef
25.
go back to reference Bilsland D, Crombie IK, Ferguson J. The photosensitivity dermatitis and actinic reticuloid syndrome: no association with lymphoreticular malignancy. Br J Dermatol 1994; 131: 209–14PubMedCrossRef Bilsland D, Crombie IK, Ferguson J. The photosensitivity dermatitis and actinic reticuloid syndrome: no association with lymphoreticular malignancy. Br J Dermatol 1994; 131: 209–14PubMedCrossRef
26.
go back to reference van Wanghe P, Dequeker J. Compliance and long-term effect of azathioprine in 65 rheumatoid arthritis cases. Ann Rheum Dis 1982; 41Suppl. 1: 40–3PubMedCrossRef van Wanghe P, Dequeker J. Compliance and long-term effect of azathioprine in 65 rheumatoid arthritis cases. Ann Rheum Dis 1982; 41Suppl. 1: 40–3PubMedCrossRef
27.
go back to reference Aithal GP, Mansfield JC. Review article: the risk of lymphoma associated with inflammatory bowel disease and immunosuppressive treatment. Aliment Pharmacol Ther 2001; 15: 1101–8PubMedCrossRef Aithal GP, Mansfield JC. Review article: the risk of lymphoma associated with inflammatory bowel disease and immunosuppressive treatment. Aliment Pharmacol Ther 2001; 15: 1101–8PubMedCrossRef
28.
go back to reference Asawanonda P. Chronic actinic dermatitis developing during narrowband UVB phototherapy for psoriasis. Photodermatol Photoimmunol Photomed 2004; 20: 66–7PubMedCrossRef Asawanonda P. Chronic actinic dermatitis developing during narrowband UVB phototherapy for psoriasis. Photodermatol Photoimmunol Photomed 2004; 20: 66–7PubMedCrossRef
29.
go back to reference Fujii N, Uetsu N, Hamakawa M, et al. Chronic actinic dermatitis developed during phototherapy for psoriasis. Photodermatol Photoimmunol Photomed 2002; 18: 157–9PubMedCrossRef Fujii N, Uetsu N, Hamakawa M, et al. Chronic actinic dermatitis developed during phototherapy for psoriasis. Photodermatol Photoimmunol Photomed 2002; 18: 157–9PubMedCrossRef
30.
go back to reference MacKenzie LA, Frain-Bell W. The construction and development of a grating monochromator and its application to the study of the reaction of the skin to light. Br J Dermatol 1973; 89: 251–64PubMedCrossRef MacKenzie LA, Frain-Bell W. The construction and development of a grating monochromator and its application to the study of the reaction of the skin to light. Br J Dermatol 1973; 89: 251–64PubMedCrossRef
31.
go back to reference Wulf HC, Brodthagen H. Solar simulators: modifications for testing with visible light. Acta Derm Venereol 1983; 63: 240–2PubMed Wulf HC, Brodthagen H. Solar simulators: modifications for testing with visible light. Acta Derm Venereol 1983; 63: 240–2PubMed
33.
go back to reference Dawe RS, Green CM, MacLeod TM, et al. Daisy, dandelion and thistle contact allergy in the photosensitivity dermatitis and actinic reticuloid syndrome. Contact Dermatitis 1996; 35: 109–10PubMedCrossRef Dawe RS, Green CM, MacLeod TM, et al. Daisy, dandelion and thistle contact allergy in the photosensitivity dermatitis and actinic reticuloid syndrome. Contact Dermatitis 1996; 35: 109–10PubMedCrossRef
34.
go back to reference Fotiades J, Soter NA, Lim HW. Results of evaluation of 203 patients for photosensitivity in a 7.3-year period. J Am Acad Dermatol 1995; 33: 597–602PubMedCrossRef Fotiades J, Soter NA, Lim HW. Results of evaluation of 203 patients for photosensitivity in a 7.3-year period. J Am Acad Dermatol 1995; 33: 597–602PubMedCrossRef
35.
go back to reference Neild VS, Hawk JL, Eady RA, et al. Actinic reticuloid with Sezary cells. Clin Exp Dermatol 1982; 7: 143–8PubMedCrossRef Neild VS, Hawk JL, Eady RA, et al. Actinic reticuloid with Sezary cells. Clin Exp Dermatol 1982; 7: 143–8PubMedCrossRef
36.
go back to reference O’Reilly FM, McKenna D, Murphy GM. Is monochromatic irradiation testing useful in the differentiation of drug-induced photosensitivity from chronic actinic dermatitis? Clin Exp Dermatol 1999; 24: 118–21PubMedCrossRef O’Reilly FM, McKenna D, Murphy GM. Is monochromatic irradiation testing useful in the differentiation of drug-induced photosensitivity from chronic actinic dermatitis? Clin Exp Dermatol 1999; 24: 118–21PubMedCrossRef
38.
go back to reference Addo HA, Ferguson J, Frain-Bell W. Thiazide-induced photosensitivity: a study of 33 subjects. Br J Dermatol 1987; 116: 749–60PubMedCrossRef Addo HA, Ferguson J, Frain-Bell W. Thiazide-induced photosensitivity: a study of 33 subjects. Br J Dermatol 1987; 116: 749–60PubMedCrossRef
39.
go back to reference Ferguson J, Addo HA, Johnson BE et al. Quinine induced photosensitivity: clinical and experimental studies. Br J Dermatol 1987; 117: 631–40PubMedCrossRef Ferguson J, Addo HA, Johnson BE et al. Quinine induced photosensitivity: clinical and experimental studies. Br J Dermatol 1987; 117: 631–40PubMedCrossRef
40.
go back to reference Dawe R, Russell S, Ferguson J. Borrowing from museums and industry: two photoprotective devices. Br J Dermatol 1996; 135: 1016–7PubMedCrossRef Dawe R, Russell S, Ferguson J. Borrowing from museums and industry: two photoprotective devices. Br J Dermatol 1996; 135: 1016–7PubMedCrossRef
41.
go back to reference Moseley H, Cameron H, MacLeod T, et al. New sunscreens confer improved protection for photosensitive patients in the blue light region. Br J Dermatol 2001; 145: 789–94PubMedCrossRef Moseley H, Cameron H, MacLeod T, et al. New sunscreens confer improved protection for photosensitive patients in the blue light region. Br J Dermatol 2001; 145: 789–94PubMedCrossRef
42.
go back to reference Kapur N, Creamer D, Hawk J. Incipient osteomalacia occurring in chronic actinic dermatitis. Clin Exp Dermatol 2000; 25: 384–5PubMedCrossRef Kapur N, Creamer D, Hawk J. Incipient osteomalacia occurring in chronic actinic dermatitis. Clin Exp Dermatol 2000; 25: 384–5PubMedCrossRef
43.
go back to reference Thurman JE, Mooradian AD. Vitamin supplementation therapy in the elderly. Drugs Aging 1997; 11: 433–49PubMedCrossRef Thurman JE, Mooradian AD. Vitamin supplementation therapy in the elderly. Drugs Aging 1997; 11: 433–49PubMedCrossRef
44.
go back to reference Nedorost ST, Stevens SR. Diagnosis and treatment of allergic skin disorders in the elderly. Drugs Aging 2001; 18: 827–35PubMedCrossRef Nedorost ST, Stevens SR. Diagnosis and treatment of allergic skin disorders in the elderly. Drugs Aging 2001; 18: 827–35PubMedCrossRef
45.
go back to reference Rackoff PJ, Rosen CJ. Pathogenesis and treatment of glucocorticoid-induced osteoporosis. Drugs Aging 1998; 12: 477–84PubMedCrossRef Rackoff PJ, Rosen CJ. Pathogenesis and treatment of glucocorticoid-induced osteoporosis. Drugs Aging 1998; 12: 477–84PubMedCrossRef
46.
go back to reference Leigh IM, Hawk JL. Treatment of chronic actinic dermatitis with azathioprine. Br J Dermatol 1984; 110: 691–5PubMedCrossRef Leigh IM, Hawk JL. Treatment of chronic actinic dermatitis with azathioprine. Br J Dermatol 1984; 110: 691–5PubMedCrossRef
47.
go back to reference Holme SA, Duley JA, Sanderson J, et al. Erythrocyte thiopurine methyl transferase assessment prior to azathioprine use in the UK. Q J Med 2002; 95: 439–44CrossRef Holme SA, Duley JA, Sanderson J, et al. Erythrocyte thiopurine methyl transferase assessment prior to azathioprine use in the UK. Q J Med 2002; 95: 439–44CrossRef
48.
go back to reference Norris PG, Camp RD, Hawk JL. Actinic reticuloid: response to cyclosporine. J Am Acad Dermatol 1989; 21: 307–9PubMedCrossRef Norris PG, Camp RD, Hawk JL. Actinic reticuloid: response to cyclosporine. J Am Acad Dermatol 1989; 21: 307–9PubMedCrossRef
49.
go back to reference Waldmann V, Kempf W, Burg G, et al. Kaposi-Sarkom unter Cyclosporin-A-Therapie bei aktinischem Retikuloid. Hautarzt 1997; 48: 262–5PubMedCrossRef Waldmann V, Kempf W, Burg G, et al. Kaposi-Sarkom unter Cyclosporin-A-Therapie bei aktinischem Retikuloid. Hautarzt 1997; 48: 262–5PubMedCrossRef
50.
go back to reference Kovarik JM, Koelle EU. Cyclosporin pharmacokinetics in the elderly. Drugs Aging 1999; 15: 197–205PubMedCrossRef Kovarik JM, Koelle EU. Cyclosporin pharmacokinetics in the elderly. Drugs Aging 1999; 15: 197–205PubMedCrossRef
51.
go back to reference Parodi A, Gallo R, Guarrera M, et al. Natural alpha interferon in chronic actinic dermatitis: report of a case. Acta Derm Venereol 1995; 75: 80PubMed Parodi A, Gallo R, Guarrera M, et al. Natural alpha interferon in chronic actinic dermatitis: report of a case. Acta Derm Venereol 1995; 75: 80PubMed
52.
go back to reference Nousari HC, Anhalt GJ, Morison WL. Mycophenolate in psoralen-UV-A desensitization therapy for chronic actinic dermatitis. Arch Dermatol 1999; 135: 1128–9PubMedCrossRef Nousari HC, Anhalt GJ, Morison WL. Mycophenolate in psoralen-UV-A desensitization therapy for chronic actinic dermatitis. Arch Dermatol 1999; 135: 1128–9PubMedCrossRef
Metadata
Title
Chronic Actinic Dermatitis in the Elderly
Recognition and Treatment
Author
Dr Robert S. Dawe
Publication date
01-03-2005
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 3/2005
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.2165/00002512-200522030-00002

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