Actinic Prurigo

Excerpt

Actinic prurigo (AP) is a rare form of idiopathic photodermatosis that primarily affects sun-exposed areas of the skin. The affected regions of the skin typically include the face, neck, and dorsal surface of the upper extremities. Sun-protected areas of the skin, such as the buttocks, have also been described. Actinic prurigo typically manifests in the spring as symmetric intensely pruritic papulonodular dermatitis and can persist into the winter months. In severe cases, excoriations, cheilitis, conjunctival disease, and scarring may develop. Actinic prurigo is typically described in prepubescent females but can occur at any age or gender. The disease has a strong genetic component and is more commonly seen in American Indians of North, Central, and South America. The diagnosis is mainly clinical. Disease management begins with sun protection and sunlight avoidance. Treatment involves topical antihistamines, corticosteroids, photochemotherapy (PUVA), as well as systemic therapies for severe cases. Without treatment, this disease course remains chronic and can persist into adulthood.