Photosensitive Dermatitis Research Articles

Photosensitive dermatitis with actinic reticuloid syndrome: an immunohistological study of the cutaneous infiltrate

Cryostat sections of skin biopsies from five patients with chronic photosensitivity dermatitis with actinic reticuloid syndrome (PDAR) have been examined immunohistologically by the alkaline phosphatase:anti-alkaline phosphatase staining technique using a panel of 24 monoclonal antibodies against lymphoid cells and their subsets. The lymphoid infiltrates in all cases had an essentially identical cellular composition, containing a mixture of T-lymphocytes, T-cell accessory cells (Langerhans cells) and other types of HLA-DR positive dermal macrophages. In two patients there was an excess of T-helper/inducer cells relative to T-suppressor cells, while in the other three patients the numbers of T-cells in these two subsets were approximately equal. Many of the infiltrating T-cells expressed activation (HLA-DR, interleukin-2 receptor) or proliferation (the Ki67 nuclear antigen, transferrin receptor) associated markers. These data indicate that a T-cell immune response is operative in cutaneous PDAR lesions.

Exfoliative Dermatitis

A prospective study in 80 exfoliative dermatitis patients over a period of 5 years establishes 41.9 years as its mean age at onset. The disease affected both males and females, with a preponderance of the former. The clinical features were identical, irrespective of the etiology. The onset of the disease was usually insidious except in staphylococcal scalled skin syndrome and drug-induced erythroderma, where it was abrupt and florid. Microcytic hypochromic anemia, elevated erythrocyte sedimentation rate, eosinophilia, low serum proteins and electrolytes were salient laboratory features. Histopathology was largely unrewarding; only in 12 patients, a good clinicohistologic correlation was present. Preexisting dermatoses, namely psoriasis, air-borne contact dermatitis, phytophotodermatitis, photosensitive and seborrheic dermatitis, and other dermatoses constituted the major etiology. Antituberculous drugs were responsible for a substantial proportion of drug-induced erythroderma. No lymphomas were found. This study outlines that some salient features of exfoliative dermatitis may show geographic variations.

Persistent light reactions. A review with opinions.

A review of persistent light reactions in South Australia is related to the European, American and Australian experience of photosensitivity and compositae dermatitis. It is argued that contact and drug photosensitising chemicals are retained in the dermis and slowly metabolised, and that actinic reticuloid will clear if all potential photosensitisers are avoided.

The relationship between exposure to fragrance materials and persistent light reaction in the photosensitivity dermatitis with actinic reticuloid syndrome.

Contact allergic sensitivity to allergens such as plants of the Compositae family is a feature of the chronic skin reaction seen in the photosensitivity dermatitis with actinic reticuloid syndrome. In fifty patients with this syndrome an increased incidence of contact allergic sensitivity to some common fragrance materials was demonstrated. Evidence is also presented, both by in vitro and in vivo studies, which indicates that a phototoxic mechanism is involved. The relevance of continued exposure to common allergens and their involvement in photosensitization mechanisms is discussed in an attempt to explain the state of 'persistent light reaction'.

Photosensitive dermatitis in two Collie working dogs

Two Collie working dogs were examined because of the sudden appearance of a skin condition. Both dogs were depressed and anorectic with an acute exudative dermatitis confined to areas of non-pigmented skin. Antibacterial treatment was instituted initially followed by long-term use of a sun-protective cream. A diagnosis of photosensitive dermatitis was made but the cause of the photosensitivity was not determined.

Delayed contact allergies in patients with photosensitivity dermatitis

Delayed contact allergies and the clinical course of the skin disease were investigated in 14 patients with photosensitivity dermatitis/actinic reticuloid and 145 patients with polymorphous light eruption type eczema. Hypersensitivity to chromium and rubber chemicals was encountered in photosensitivity dermatitis more often than in polymorphous light eruption eczema and in the comparison series of 1714 patients with other types of dermatitis. In the eczema group, delayed contact allergies to chromium, rubber chemicals, neomycin, clioquinol, balsam of Peru, fragrance and colophonium were more frequent than in the comparison group, suggesting that at least delayed contact allergy to chromium and rubber chemicals may be of significance in the development of photosensitivity in many patients who suffer eczematous reaction to sunlight.

Antinuclear antibody—negative systemic lupus erythematosus

Anti-Ro(SSA) and anti-La(SSB) antibodies are found in approximately 25% of systemic lupus erythematosus patients. These antibodies are also detected in lupus patients who fail to demonstrate a significant antinuclear antibody (ANA) titer when mouse liver is employed as the substrate. Approximately 5% to 10% of systemic lupus patients are in this category. These ANA-negative, Ro(SSA)-positive lupus patients generally demonstrate a prominent widespread photosensitive dermatitis and are frequently initially seen and evaluated by a dermatologist.

Contact allergic sensitivity to chrysanthemum and the photosensitivity dermatitis and actinic reticuloid syndrome

Of sixty-nine examples of the photosensitivity dermatitis and actinic reticuloid syndrome, nine were found to be allergically sensitive to chrysanthemum oleoresin extract. Although this extract showed evidence in vitro of a phototoxic action we were unable with in vivo studies to explain the connection between the contact allergic sensitivity and the photosensitivity. The fractions responsible for the in vitro phototoxicity appear to be different from those involved in the in vivo contact allergic sensitivity. This study provides further support for the view that in the photosensitivity dermatitis and actinic reticuloid syndrome contact allergic sensitivity is of importance.

Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome

Contact allergic sensitivity to oleoresin extracts from Compositae plants was found to be usually present in individuals suffering from the photosensitivity dermatitis and actinic reticuloid syndrome. It was demonstrated in forty-seven out of fifty-five examples of this syndrome. These results provide support for the view that contact allergic sensitivity is an important aspect of the state of chronic photosensitivity in the middle-aged and elderly male.

Contact allergic sensitivity to chrysanthemum and the photosensitivity dermatitis and actinic reticuloid syndrome

Contact allergic sensitivity to chrysanthemum and the photosensitivity dermatitis and actinic reticuloid syndrome

Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome

Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome

An anti-human T-lymphocyte antiserum: In situ identification of T cells in the skin of delayed-type hypersensitivity reactions, chronic photosensitivity dermatitis, and mycosis fungoides

A specific rabbit anti-human T-lymphocyte antiserum has been utilized in an indirect immunofluorescence method to detect T lymphocytes in situ of cryostat tissue sections from biopsies from positive delayed-type hypersensitivity reactions and from patients with chronic photosensitivity dermatitis and mycosis fungoides. The antiserum was raised against thymocytes and rendered specific against human T lymphocytes by extensive absorptions with B lymphocytes from patients with chronic lymphocytic leukemias, pooled human IgG, and erythrocytes. Specificity tests were performed in several systems and included staining of tissue sections from thymus, spleen, and lymph node; the results were recorded and fulfill the criteria for specificity demanded by the WHO/IARC-Sponsored Workshop ( Scand. J. Immunol. 1, 521, 1974). A predominance of T-lymphocytes was present in the skin infiltrate of positive delayed hypersensitivity reaction, chronic photosensitivity, and mycosis fungoides stage II.

Quinidine Photosensitivity

Photodermatitis occurring in three patients taking oral quinidine sulfate cleared when the drug was discontinued and recurred when it was readministered. The dermatitis was experimentally reproduced with long-wave ultraviolet light (UV-A, 320-400 nm) in these three patients, who also exhibited a decreased minimal erythema dose (MED) to hot quartz irradiation. Patients taking quinidine who had no dermatitis exhibited normal MEDs and normal response to UV-A. Normal subjects injected intradermally with quinidine and irradiated with UV-A showed no reaction. These observations indicate that the photosensitive dermatitis to quinidine that occurred in the three patients is idiosyncratic and that the UV-A is at least partially responsible for the development of the dermatitis that correlates with the absorption of quinidine in the UV-A range. Quinidine must be considered among the drugs that can produce photosensitive dermatitis.

The syndrome of chronic photosensitivity dermatitis and actinic reticuloid

In a Study of thirty‐four male subjects suffering from the syndrome of chronic photosensitivity dermatitis and actinic reticuloid the clinical, histological and photobiological features were such as to suggest that they were in fact examples of a single entity in which the degree of response to ultraviolet and visible light varied. Although a wide action spectrum involving UV and visible wavelengths invariably occurred with the classical clinical and histological features of actinic reticuloid (Ive et al., 1969) a broad action spectrum with similar histological appearances was also noted in some of the subjects in whom the morphological changes were those of a chronic dermatitis confined to exposed sites.

Photosensitive Dermatitis Due to Pyritinol

Lichen planus-like photosensitive dermatitis due to pyritinol hydrochloride occurred in a 62-year-old man. Pigmentation intermingled with depigmentation as melanoleukoderma remained after involution of the eruption on the forehead and occipital region. A photosensitization period of five or six weeks' duration was found, and the photopatch test was positive. This case is considered to be due to photoallergy.

PHOTOSENSITIVE DERMATITIS AND RENAL TUBULAR ACIDOSIS AFTER INGESTION OF CALCIUM CYCLAMATE

A 25-year-old airline stewardess, habitually consuming large quantities of soft drinks containing the artificial sweetener cyclamate and taking twenty packets (4 g.) or more of calcium cyclamate a day was found to have a photosensitive dermatitis and severe renal tubular acidosis, associated with hypophosphatæmia. Photoallergic dermatitis has been reported in Japan after the ingestion of cyclamates: in these patients, and in the one reported here, withdrawal of cyclamate resulted in the toxic effects abating. Previous reports on human and animal toxicity are discussed. Considering the vast numbers of individuals exposed to cyclamates, there are few reports of toxicity in man. This case-report draws attention to the danger of renal damage when ingesting the calcium derivative.

Contact photosensitivity dermatitis from sun-protective agent

Contact photosensitivity dermatitis from sun-protective agent

Photosensitive dermatitis from soaps.

Antibacterial soaps containing halogenated salicylanilides cause photosensitive skin eruptions that can be reproduced by a simplified photopatch testing technic. Twelve patients with photosensitive reactions due to soaps had positive tests to either dibromosalicylanilide or tribromosalicylanilide, or a soap solution containing these substances, but tests were negative if soap solutions free of halogenated salicylanilides were used. Of 21 patients with other dermatologic disease only one had a positive test to halogenated salicylanilides. Comparative photopatch tests in sensitive patients with a series of halogenated salicylanilides in current use showed no significant difference in the number of positive reactions to the several agents tested.

Diseases aggravated by sunlight.

Examination of a patient presenting symptoms of photosensitivity may suggest one of the following: porphyria, lupus erythematosus, Bloom's syndrome, Cockayne's syndrome, xeroderma pigmentosum, lipid proteinosis, pellagra, pellagrous dermatitis of carcinoid, Hartnup's syndrome, albinism, phenylketonuria, vitiligo, polymorphic light eruption, hydroa aestivale, drug photosensitivity or photocontact dermatitis. Methods of investigating photosensitivity are described.

Atypical Granuloma Annulare

Atypical forms of granuloma annulare are being reported with increased frequency. This may be related to increased awareness on the part of clinicians, an evolutionary change in the disease itself, or a combination of both factors. We wish to call attention to a rare variety of granuloma annulare that in its localization and certain other features simulates a photosensitivity or contact dermatitis.