Chronic actinic dermatitis in Asian skin: a Singaporean experience

Abstract

To study the characteristics of chronic actinic dermatitis (CAD) in a heterogeneous group of Singaporean patients. The photobiologicial features of all patients phototested and diagnosed with CAD from January 2005 to December 2009 were examined retrospectively. Fifty-eight patients were diagnosed as having CAD. The mean age at diagnosis was 62 years (range 35-83). Forty-one were (70.7%) Chinese, six (10.3%) Indians, eight (13.8%) Malays, and three (5.2%) Others. Forty-seven were (81.0%) male and 11 (19.0%) were female. Forty-nine (84.5%) had Fitzpatrick skin phototype IV and nine (15.5%) had phototype V. Three of 26 (11.5%) tested for human immunodeficiency virus were positive. The face, neck, and forearms were most commonly affected. Thirty-two patients (55.2%) had reduced minimal erythema dose (MED) to both ultraviolet B (UVB)and ultraviolet A (UVA), 23 patients (39.7%) had lowered MED to UVB only, while three (5.1%) had reduced MED to UVA only. Patients were followed up for a mean of 16.8 months. All were treated with photoprotection and topical steroids; however, a few required oral immunosuppression with partial improvement. In Singapore, CAD was seen more commonly in elderly Chinese males of Fitzpatrick skin phototype IV. Reduced MED to both UVB and UVA was the most common phototest finding.