Actinic conjunctivitis in children: Clinical features, relation to sun exposure, and proposed staging and treatment

Engel, Jill; Molinari, Andrea; Ostfeld, Barbara; Deen, Malik; Croxatto, O

doi:10.1016/j.jaapos.2008.10.017

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…This pattern suggests a lesion formation process for unilateral lesions either not limited to childhood, more resistant to complete remodeling, or with a lower mortality risk than bilateral lesions. One plausible explanation for the pattern of unilateral orbital lesions in LIP Nasca individuals is actinic conjunctivitis, an inflammatory orbital condition not uncommon in highland Andean populations (Engel et al, 2009). Actinic conjunctivitis results from high exposure to ultraviolet radiation, an unavoidable experience of high-altitude subsistence living, and it is characterized by hyperplasia of the vascular endothelium, a condition that encourages local angiogenesis (Beranek, 2002).…”

Section: Diachronic Changesmentioning

confidence: 99%

Using a multimethod life history approach to navigate the osteological paradox: A case study from Prehispanic Nasca, Peru

McCool

Anderson

Kennett

2021

American J Phys Anthropol

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Objectives: We leverage recent bioarchaeological approaches and life history theory to address the implications of the osteological paradox in a study population. The goal of this article is to evaluate morbidity and mortality patterns as well as variability in the risk of disease and death during the Late Intermediate period (LIP; 950-1450 C.E.) in the Nasca highlands of Peru. We demonstrate how the concurrent use of multiple analytical techniques and life history theory can engage the osteological paradox and provide salient insights into the study of stress, frailty, and resilience in past populations.Materials and methods: Crania from LIP burial contexts in the Nasca highlands were examined for cribra orbitalia (n = 325) and porotic hyperostosis (n = 270). All age groups and both sexes are represented in the sample. Survivor/nonsurvivor analysis assessed demographic differences in lesion frequency and severity. Hazard models were generated to assess differences in survivorship. The relationship between dietary diversity and heterogeneity in morbidity was assessed using stable δ 15 N and δ 13 C isotope values for bone collagen and carbonate. One hundred and twenty-four crania were directly AMS radiocarbon dated, allowing for a diachronic analysis of morbidity and mortality. Results: The frequency and expression of both orbital and vault lesions increases significantly during the LIP. Survivor/nonsurvivor analysis indicates cranial lesions co-vary with frailty rather than robusticity or longevity. Hazard models show (1) decreasing survivorship with the transition into the LIP, (2) significantly lower adult life expectancy for females compared to males, and (3) individuals with cranial lesions have lower survivorship across the life course. Stable isotope results show very little dietary diversity. Mortality risk and frequency of pathological skeletal lesions were highest during Phase III (1300-1450 C.E.) of the LIP. Conclusion:Results provide compelling evidence of increasing physiological stress and mortality in the Nasca highlands during the LIP, but also reveal substantial heterogeneity in frailty and the risk of death. Certain members of society experienced a heavier disease burden and higher mortality compared to their contemporaries. Elevated levels of disease and lethal trauma among females account for some of the sex

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Section: Diachronic Changesmentioning

confidence: 99%

Using a multimethod life history approach to navigate the osteological paradox: A case study from Prehispanic Nasca, Peru

McCool

Anderson

Kennett

2021

American J Phys Anthropol

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“…Children with actinic conjunctivitis frequently complain of a burning itchy sensation and relief is gained with the use of steroids. Actinic conjunctivits, in its earliest stages, is frequently misdiagnosed as vernal conjunctivitis but without papillary reaction (Engel et al, 2009). Despite that actinic conjunctivitis could be considered as a differential diagnosis, authors have observed that in some cases could coexist with AOD.…”

Section: Skin Co-morbiditiesmentioning

confidence: 99%

Allergic Conjunctivitis: An Immunological Point of View

Robles-Contreras¹,

Santacruz²,

Ayala³

et al. 2011

Conjunctivitis - A Complex and Multifaceted Disorder

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Actinic conjunctivitis and its relationship with prurigo in an indigenous population from the Highlands of Chiapas, Mexico

Alamillo-Velazquez,

Ortiz-Morales,

Gonzalez-Gonzalez

et al. 2024

Int Ophthalmol

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PurposeActinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis affecting high-risk populations. We analysed the clinical manifestations and onset of actinic conjunctivitis (AC) and its relationship with prurigo (AP) in a susceptible population. MethodsAn observational and cross-sectional study was performed on the Indigenous populations from the highlands of Chiapas, Mexico. A thorough dermatologic and ophthalmologic examination was performed on patients attending a primary health care centre. Clinical features, labour and environmental factors, onset timing, and clinical staging of AC and AP were analysed. ResultsOf 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC and 14 patients (25.9%) AP. Mean age of diagnosis was 36.18 ± 18.52 years (range: 6-70 years). Mean residence altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 hours a day (range: 0.5 -12 h). 90.7% reported exposure to biomass fuels when cooking, and 50% to farm animals. AC was the sole manifestation in 70% of cases. All patients had nasal and temporal photo-exposed conjunctiva affected.12.9% of eyes were classi ed as stage-1, 64.8% as stage-2, and 22.2% stage-3. 83.3% of the patients had a hyperpigmented lesion and 35.1% had an evaporative dry eye disease. ConclusionsThe prevalence of AC was 1.8%. AC may be the initial or sole manifestation of AP.AC clinical manifestations included a symmetric papillo-follicular conjunctival reaction, evaporative dry eye disease, linear leucoma, hyperpigmented lesions, and pseudo-pterygia formation. What was known before?Prurigo is a rare photo dermatosis affecting the conjunctiva in almost half of the patients.Risk factors associated with actinic conjunctivitis include genetic susceptibility, living at high altitudes, excessive sunlight, and bio-mass exposure.Actinic conjunctivitis starts early in life as pruritic conjunctival hyperaemia, progressing to pseudopterygia formation over the cornea, affecting the patient´s vision. What this study adds?Actinic conjunctivitis may present as the sole or initial and most prominent manifestation of prurigo.

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Actinic conjunctivitis in children: Clinical features, relation to sun exposure, and proposed staging and treatment

Cited by 5 publications

References 9 publications

Using a multimethod life history approach to navigate the osteological paradox: A case study from Prehispanic Nasca, Peru

Using a multimethod life history approach to navigate the osteological paradox: A case study from Prehispanic Nasca, Peru

Allergic Conjunctivitis: An Immunological Point of View

Actinic conjunctivitis and its relationship with prurigo in an indigenous population from the Highlands of Chiapas, Mexico

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