Abstract

Chronic actinic dermatitis (CAD) is a photosensitivity disorder that is defined as a persistent eczematous eruption in sunexposed areas. The pathogenesis of CAD has not been completely understood. It typically afflicts men in the fifth decade of life or older. It manifested as an eczematous process with pruritus, erythematous and lichenified plaques involving sun-exposed areas mostly head and neck and distal extremities, sparing areas covered by clothing. Phototesting is recommended for further evaluation of suspected CAD. The key histological diagnostic clues included a brisk lymphoid infiltrate, eosinophils, plasma cells, and prominent dermal dendrocytes with multinucleated cells in the background or reticular fibroplasias. Current management for CAD includes broad-spectrum sunscreens, physical protection from sunlight, allergen avoidance, topical corticosteroids and tacrolimus, systemic corticosteroids and immunosuppressive agents such as azathioprine, cyclosporine, and mycophenolate mofetil, and photo (chemo) therapy.