Chronic photosensitive dermatitis

Last Updated: 2019-08-27

Author(s): Anzengruber, Navarini

Frain-Bell et al. 1974

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

Only older men.

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

Medical history

Clinic

If necessary biopsy and TCR PCR

Photoprovocation testing, if necessary

Photopatch testing, if necessary

  • 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.