Chronic photosensitive dermatitis

Frain-Bell et al. 1974

Chronic, UV-induced dermatitis, exclusively in older men. Subtype of chronic actinic dermatitis.

Exclusively older men.

Older men who usually had multiple positive findings in the patch (epicutaneous) or photopatch test. This leads to chronic eczema.

Anamnesis

Clinic

If necessary, biopsy

Photoprovocation testing

Photopatch testing

• 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.