The clinical features and management of actinic prurigo: a retrospective study

Actinic prurigo (AP) is a rare photodermatosis, mostly affecting young American Indian girls. A retrospective descriptive study was done in the National Skin Centre, Singapore. Our patients have different characteristics compared to the previous reports. Of the 11 cases found between 1990 and 1998, 10 were male. All of the patients had the onset in adulthood. The condition was recognised by the presence of papules and nodules on the sun-exposed areas, predominantly on forearms and back of hands. Phototests revealed lowered minimal erythemal dose (MED) to ultraviolet A (UVA) alone in 2 patients and lowered MED to both UVA and UVB in another 4 patients. Patch, photopatch and histological examination did not show any significant finding. Sun protection, emollients and topical steroid were the baseline treatment for all patients. Intralesional steroid, systemic steroid, psoralen plus ultraviolet A (PUVA), azathioprine and thalidomide were used in some patients, with variable results.