BackgroundPrevious reports have characterized photosensitivity in atopic dermatitis (AD), but with differences in terminology and criteria. ObjectiveThis study aims to assess outcomes in 139 AD patients referred for photodiagnostic testing and to establish diagnostic criteria for photosensitivity in AD. MethodsClinical and photodiagnostic data were reviewed, categorizing photosensitivity into Photo-Exacerbated AD (PEAD), Photo-Sensitive AD (PSAD), and Chronic Actinic Dermatitis (CAD). ResultsOf the patient cohort, mean age was 42.6±16.7 years and 61.9% were male. PEAD patients (51.1%) had normal monochromator phototesting. PSAD patients (7.9%) displayed slight-to-moderate UVA sensitivity (≥30% of normal minimal erythema dose [MED]) and mostly normal/slightly reduced UVB MEDs (≥80% of normal MED). Conversely, 41% of patients had CAD and 93% of this group demonstrated significant UVB sensitivity, with very low UVB MEDs (<80% of normal MED) and/or very low UVA MEDs (<30% of normal MED). No significant differences in sex, age, or skin phototype were observed between groups. Serial phototesting revealed changes in photosensitivity status over time in eight patients. LimitationsSmall sample size and retrospective design. ConclusionsThis study highlights the heterogeneity of photosensitivity patterns in AD patients and the importance of follow-up assessments due to potential shifts in disease spectrum over time.
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