Actinic reticuloid

Ive 1969

Actinic reticuloid

Actinic reticuloid is a subtype of chronic actinic dermatitis. Histologically, there is a similarity to a T-cell lymphoma, so that it is also referred to as a pseudolymphoma.

Large, pruritic, erythematous, scaly papules and plaques in light-exposed areas. In some cases, erythroderma may occur, facies leontina (in the maximum form).

Anamnesis

Clinic

If necessary, biopsy

Photoprovocation testing

In addition, rhagades may appear on the hands, an ectropion on the eye and a facies leontina

UV protection

• Calcineurin inhibitors
  • Tacrolimus
    • Protopic®-ointment 0.1%  2x daily for 2 weeks
  • Pimecrolimus
    • Elidel®-cream 1% 2x daily for 2 weeks
• Systemic glucocorticoids
  • Prednisolone (Spiricort®) p.o. 0.5-1.0 mg/kg/d, in tapering application frequency
• Azathioprine (Imurek®) p.o. 1x tgl
  • Initially: 1-3 mg/kg bw
  • Progress: reduction by approx. 0.5 mg/kg bw to the lowest still effective dosage.
  • CAVE: In case of concomitant administration of allopurinol, a reduction of the azathioprine dose to a ¼ is indicated.
  • Prior to exclusion of thiopurine methyltransferase deficiency.
• Ciclosporin (Sandimmun®) p.o. 3-5 mg/kg bw daily
  • Take independently of meals
• PUVA
.

1. Paek SY, Lim HW. Chronic actinic dermatitis. Dermatol Clin. 2014 Jul;32(3):355-61
2. Vandermaesen J, Roelandts R, Degreef H. Light on the persistent light reaction-photosensitivity dermatitis-actinic reticuloid syndrome. J Am Acad Dermatol. 1986 Oct;15(4 Pt 1):685-92.