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Actinic Prurigo (Photosensitive Dermatosis)

Familial photosensitive disease with HLA-DR4 association: thalidomide treatment response

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Actinic Prurigo (Photosensitive Dermatosis)?

Actinic prurigo is a less common photodermatosis subtype than polymorphic light eruption (PLE), with a strong genetic predisposition. HLA-DRB1*0407 carriage 60-90%; mestizo populations (Mexico, Peru, Bolivia) have prevalence of 1-3%, while in Europe/USA it is rare.

Pathophysiology: type IV (delayed) hypersensitivity to UVA-UVB light, T cell-mediated, and Langerhans cell-rich infiltrate. Onset is in childhood-adolescence (mean age 7-13 years); progression slows or remits in adulthood (50-75%).

Symptoms: extremely pruritic, excoriated papules, nodules, plaques on sun-exposed areas (face, dorsa of hands, V neck); cheilitis (lower lip 65%) and conjunctivitis (45%) are characteristic. Differentiates it from PLE (PLE has no cheilitis-conjunctivitis, attacks shorter). Treatment options include sun protection, topical steroids, phototherapy desensitization, and severe cases respond well to thalidomide (50-100 mg/day).

Symptoms

Pruritic excoriated papules in sun-exposed areas
Cheilitis (lower lip - characteristic)
Conjunctivitis and pterygium (45%)
Lichenified plaques (chronic)
Childhood-adolescent onset
Symptoms persist throughout the year (with summer exacerbation)

Risk Factors

Latin American (mestizo) ancestry
HLA-DRB1*0407 carriage
Childhood-adolescent age
Female gender (slight predominance)
High altitude (intense UV)
Family history of photosensitivity

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent itchy lesions on sun-exposed areas
  • Lower lip swelling and chapping (cheilitis)
  • Eye redness, photophobia (conjunctivitis)
  • Severe sun-induced rashes (childhood)
  • Mestizo ethnicity + photosensitivity history
  • PLE diagnosis without response to treatment

Treatment Methods

01
Strict sun protection (SPF 50+, broad-spectrum)
02
Topical glucocorticoid (mild-moderate cases)
03
Topical tacrolimus (steroid sparing)
04
PUVA or narrowband UVB (desensitization, before spring)
05
Thalidomide (50-100 mg/day, severe cases)
06
Cyclosporine, methotrexate (refractory cases)

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dermatoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.