Photodermatoses represent a heterogeneous collection of disorders unified by the characteristic of being provoked through exposure to ultraviolet radiation. Generally, these conditions are classified into the following categories: immunologically mediated photodermatoses, chemical- and drug-induced photosensitivity, photoaggravated dermatoses and photosensitivity associated with defective DNA repair mechanisms or chromosomal instabilities. The list of photodermatoses is extensive, and each individual photodermatosis is understood to a different extent. Regardless, there exists a paucity of information with regards to the clinical presentation among those with skin of colour. With ever-changing global demographics, recognition of photosensitive disorders in a diverse population is essential for accurate diagnoses and therapeutic guidance. The scope of this article seeks to review the epidemiology and clinical variability in presentation of such photodermatoses in patients with skin of colour.
An African American male in his 50s with a longstanding history of atopic dermatitis presented with a 20-to 30-year medical history of occasionally pruritic erythematous papules involving the trunk and extremities. He denied associated fevers, chills, night sweats, weight loss, joint pain, cough, difficulty breathing, or chest pain.Findings from the physical examination revealed red-brown monomorphic papules coalescing into plaques on the face, trunk, and extremities (Figure , A and B). There were thin erythematous plaques with overlying scale on bilateral extensor upper and lower extremities. A 4-mm punch biopsy specimen from his right upper extremity was obtained and stained with hematoxylin-eosin for histopathologic analysis. Periodic acid-Schiff and acid-fast bacilli stains were also performed. Clinical image A Clinical image B Histopathologic image C Figure. A, Distribution of papules over the chest, abdomen, and upper extremities. B, Diffuse distribution of papules over the back with some papules coalescing into plaques. C, Hematoxylin-eosin stain (original magnification, ×10). WHAT IS YOUR DIAGNOSIS? A. Disseminated granuloma annulare B. Erythrodermic sarcoidosis C. Mycosis fungoides D. Tuberculid Clinical Review & Education
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