Chronic actinic dermatitis

LAST UPDATED: Aug 03, 2021

Introduction

Chronic actinic dermatitis is an uncommon, persistent, often disabling UV-induced eczema.

This chapter is set out as follows:

Aetiology
History
Clinical findings
Images
Management

Aetiology

Aetiology unknown
It is mainly found in older men but can arise in younger, atopic patients (the prognosis in this latter group is better)

History

Itch and erythema are often provoked easily by UV radiation
The skin is sensitive to UVB, UVA (most window glass will not protect), and sometimes visible light eg from fluorescent lights

Clinical findings

The skin is eczematous
Patients can go on to develop a chronic dermatitis with thick plaques on sun-exposed areas

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Management

Step 1: general measures

Provide a patient information leaflet on chronic actinic dermatitis
Provide a patient information leaflet on UV protection

Step 2: referral

For photo-testing, and possibly patch testing (one of the differentials is an airbourne contact allergic dermatitis)
In extreme cases immunosuppressants, such as azathioprine or methotrexate, may be needed

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Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. All named individuals and organisations maintain copyright for the relevant images.