[Chronic actinic dermatitis. Therapy with systemic PUVA and mycophenolate mofetil]

Area of Science:

• Dermatology
• Immunodermatology

Background:

• A 66-year-old male patient initially diagnosed with psoriasis in 2001 and later with atopic dermatitis in 2007 presented with treatment challenges.
• The patient experienced recurrent exacerbations, including erythroderma and severe superinfections, necessitating hospitalization despite initial treatments with fumarates and methotrexate.

Observation:

• A revised diagnosis of chronic actinic dermatitis was made due to the patient's clinical presentation, particularly severe involvement of the head and dorsal hands.
• Initial immunosuppressive therapy with mycophenolate mofetil (1000 mg/day) showed a limited response.

Findings:

• The addition of photo-hardening with systemic photochemotherapy (PUVA) to mycophenolate mofetil therapy resulted in a near-complete recovery within six months.
• This combined therapeutic approach proved effective in managing the recalcitrant chronic actinic dermatitis.

Implications:

• This case highlights the importance of accurate diagnosis in complex dermatological conditions.
• Combined immunosuppression and photochemotherapy can be a viable treatment strategy for severe chronic actinic dermatitis.
• Further research into optimizing combination therapies for actinic dermatitis is warranted.