The clinical features and management of actinic prurigo: a retrospective study

Abstract

Actinic prurigo (AP) is a rare photodermatosis, mostly affecting young American Indian girls. A retrospective descriptive study was done in the National Skin Centre, Singapore. Our patients have different characteristics compared to the previous reports. Of the 11 cases found between 1990 and 1998, 10 were male. All of the patients had the onset in adulthood. The condition was recognised by the presence of papules and nodules on the sun-exposed areas, predominantly on forearms and back of hands. Phototests revealed lowered minimal erythemal dose (MED) to ultraviolet A (UVA) alone in 2 patients and lowered MED to both UVA and UVB in another 4 patients. Patch, photopatch and histological examination did not show any significant finding. Sun protection, emollients and topical steroid were the baseline treatment for all patients. Intralesional steroid, systemic steroid, psoralen plus ultraviolet A (PUVA), azathioprine and thalidomide were used in some patients, with variable results.

Pentoxifylline in the Treatment of Actinic Prurigo

“…However, pruritus is the predominant symptom which is usually noted at early phases of the disease [19]. AP is often refractory to therapy, although topical, intralesional or systemic steroids [6], psoralen plus ultraviolet A [20], azathioprine [2], cyclosporine [8]and thalidomide [9]have been used with variable results. In our patients, oral intake of PTX induced a significant improvement in overall assessment.…”

“…Lesions consist of excoriated itchy papular or nodular eruptions predominantly on the face, forearms and back of hands. Family cases are not infrequent, usually lasting throughout childhood and adolescence, tending to wane and even to clear in late adolescence or during adult life [1, 2, 3]. …”

Actinic Prurigo in an Albanian Girl

“…It was first described in South and Central America and among Native Americans in Canada and in the United States (1). Cases have also been reported among European Caucasians (2,3) and Asians (4), but in southern Europe, it is largely unknown.…”

“…The eruption, although typically seasonal, may be present all year (7). In 40% of patients, a personal or family history of atopy may be obtained (4).…”

“…Broad‐spectrum sunscreens and rigorous photoprotection together with strong topical steroids may be helpful in some patients, whereas in others, antimalarials, beta‐carotenes, or psoralen and ultraviolet A therapy have been tried with variable results (4–6). The therapeutic efficacy of thalidomide in AP is striking and is considered by some diagnostic (5).…”