Chronic actinic dermatitis: an analysis at a single institution over 25 years

Abstract

Background: Chronic actinic dermatitis (CAD) is a rare photosensitivity disorder with scant epidemiologic data.

Objective: To evaluate demographic data and results of photopatch and patch tests over a 25-year period.

Methods: Retrospective chart review of patients with CAD from 1993 to 2009.

Results: Forty patients had a mean age of 57.8 years, and 27 (67.5%) were men. Twelve patients (30%) were skin types I and II, and 17 (42.5%) were skin types V and VI. Nine patients (22.5%) were younger than 50 years, and 4 of these (44.4%) were men. One of the nine patients (11.1%) was skin type I, and 4 (44.4%) were skin types V and VI. Carba mix and para-phenylenediamine were the two most commonly positive agents in patch tests. Sunscreens and plants and plant derivatives were the most commonly positive agents in photopatch tests.

Conclusions: Our findings suggest a trend of two new classes of North American patients at our institution being diagnosed with CAD-younger women with skin types IV to VI and older men with skin types I to III. We observed a greater-than-expected number of positive patch-test reactions to para-phenylenediamine. We suggest that patch testing and photopatch testing of individuals may be useful adjuncts in the assessment of CAD.