| • | especially with history of exposure to potential airborne contact allergens (e.g. colophony or the Compositae oleoresins) |
| • | the following syndromes are now considered to be variants of this single condition: |
| • | persistent light reactivity |
| • | photosensitivity dermatitis |
clinical:
| • | persistent eruption of generally eczematous character, possible associated with infiltrated papules and plaques |
| • | predominantly affecting exposed skin, although sometimes spreading to covered areas |
| • | histology: appearance consistent with chronic eczema, with or without lymphoma like changes |
photobiologic:
| • | phototesting of the skin (to demonstrate above) is always necessary to confirm the diagnosis.... |
| • | reduction of minimal erythema dose to UVB (and in majority of patients, also UVA) |
Actinic reticuloid
| • | may be regarded as the most severe expression of chronic actinic dermatitis |
| • | almost exclusively effects older men (with only one case report in a female) |
| • | photodistributed but often with extension to covered skin; erythroderma in many |
| • | severe and intractable pruritis |
| • | generalized LAN; circulating Sezary cells in 10% |
| • | sensitive to both UVB and UVA and occasionally to visible light |
| • | may be a consequence of persistent photoallergic photosensitivity |
| • | predominance of CD8+ T-cells in lesional skin (vs. MF which is a tumor of CD4+ T-cells) |
| • | this difference and the photosensitivity help to distinguish actinic reticuloid from MF |
|