Chronic actinic dermatitis. An analysis of 51 patients evaluated in the United States and Japan

The Natural History of Chronic Actinic Dermatitis

“…Studies from Europe reported that most patients also have allergic contact dermatitis, [3][4][5][6] although this has been detected in a lower proportion in a North American series. 7,8 In our experience, this oftendisabling condition improves, to a varying degree, in most patients after investigation and appropriate advice. Sustained improvement usually depends on continued careful UV/visible light and allergen avoidance.…”

“…2,[5][6][7]14 The absence of diagnostic phototesting facilities in some regions may lead to CAD not being recognized, with, for example, only the allergic contact dermatitis component being diagnosed. Nevertheless, CAD probably occurs worldwide.…”

Allergic Contact and Photoallergic Contact Dermatitis to Plant and Pesticide Allergens

“…On day 2, the MED responses to UV-A (MED-A) and UV-B (MED-B) were quantified, the sites exposed to visible light were evaluated, and 1 set of photo-patch tests was exposed to UV-A (10 J/cm 2 or 50% of the MED-A). 1 The patches on the nonirradiated site were kept covered for an additional 24 hours and were removed for the initial evaluation at 48 hours. The exception was 6-methylcoumarin, which was irradiated 30 to 60 minutes after application.…”

Chlamydia trachomatis Infection and Photosensitive Dermatoses

“…With progression to CAD, UVA+/-UVB irradiation alone may trigger the immune response at any site, possibly by the continuing formation of antigenic photo products from the ubiquitous endogenous carrier protein alone. In cases where there is no preceding history of photoallergy, CAD may represent an end stage of a number of predisposing conditions like allergic contact dermatitis to substances with phototoxic potential, endogenous eczema [7], photosensitivity from oral medication, possibly PLE and human immunodeficiency virus infection [8]. Finally CAD also appears to arise de novo in normal subjects [9].…”