Actinic prurigo is photodermatosis that can be difficult to manage. It may be due to a delayed hypersensitivity reaction to autoantigens formed secondary to ultraviolet radiation. It may be related to certain HLA types.
Clinical features:
(1) occurrence in sun-exposed skin, typically in adult women
(2) erythematous skin lesions (papules and plaques)
(3) intense pruritus
(4) variable family history. It may occur as a hereditary disorder, especially in Native Americans and mestizos in Latin America. It can also occur as a sporadic disorder.
(5) exclusion of alternative explanations
It tends to improve when sun exposure is low (such as during the winter) and to get worse with prolonged sun exposure.
Management may include:
(1) protection from light
(2) topical or systemic corticosteroids
(3) antihistamines
(4) thalidomide
(5) low-dose phototherapy (PUVA, UVB)
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