Actinic reticuloid

Last Updated: 2019-08-26

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Ive 1969

Actinic reticuloid

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

Large-area, pruriginal, erythematous, scaly papules and plaques in light-exposed areas. In some cases, erythroderma can occur, Facies Leontina (in its maximum form).

Medical history
Clinic
Biopsy, if necessary
Photoprovocation testing, if necessary,

Rhagades can also occur on the hands, an ectropion on the eye and a facies leontina on the face.

UV-Schutz

  • Calcineurin inhibitors
    • Tacrolimus
      • Protopic® Ointment 0.1% 2x daily 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 creeping application frequency
  • Azathioprine (Imurek®) p.o. 1x daily
    • Initial: 1-3 mg/kg bw
    • Course: Reduction by approx. 0.5 mg/kg bw to the lowest still effective dosage.
    • CAVE: If allopurinol is administered simultaneously, a reduction of the azathioprine dose to ¼ is indicated.
    • Prior to this, a thiopurine methyltransferase deficiency is excluded.
  • Ciclosporin (Sandimmun®) p.o. 3-5 mg/ kg bw daily
    • To be taken 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.