The conjunctivitis of solar (actinic) prurigo

Solar (actinic) prurigo (SP) is an abnormal reaction to sunlight that affects mostly the Indian and mestizo populations of America, and is well known in Canada and the United States. It is quite common in Mexico, Central, and South America, although rare in Europe. It usually starts in childhood in both sexes and in about 30-50% of cases involves the oral and ocular mucosa. In this study we present the clinical and histopathologic conjunctival findings in 11 of 105 children with SP. Clinically the most important features were photophobia, some degree of pterygium, and pinguecula, hyperemia, Trantas' dots, hyaline exudate, and follicles. Histopathologically the changes were epithelial, such as epidermoid metaplasia and absence of goblet cells, and stromal changes, which were the most diagnostically relevant. These consisted of lymphocytic inflammatory infiltrates, usually with eosinophils, melanosis, and solar elastosis. We believe this constellation of criteria will be useful for a better characterization of SP.