HLA typing in actinic prurigo.
ABSTRACT Thirty-two actinic prurigo patients of Cree ancestry underwent human lymphocyte antigen (HLA) typing and were compared with 32 control subjects of Cree ancestry. We found a significantly increased frequency of HLA-A24 and Cw4 antigens and a significant decrease in the frequency of the A3 antigen in actinic prurigo patients. These HLA associations may be helpful in determining whether actinic prurigo is a distinct disease or a variant of polymorphous light eruption.
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ABSTRACT: 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.Photodermatology Photoimmunology and Photomedicine 11/1999; 15(5):183-7. · 1.52 Impact Factor
Article: The idiopathic photodermatoses.[Show abstract] [Hide abstract]
ABSTRACT: The idiopathic photodermatoses present a challenge for dermatologists. Although, as in other specialty areas, the classical clinical presentation produces few problems, it is the severe forms and overlap cases that cause the most difficulty. It is fortunate that the semi-objective investigation of phototesting is available, which, when conducted carefully, reveals so much about the nature of this group of conditions. This essential investigation not only helps achieve a diagnosis, but also affords material for study and a means of monitoring therapy response or progress towards spontaneous resolution. Although these conditions are grouped together, throughout this century we have seen a continuing process of distinct diseases emerging as a consequence of careful clinical observation and investigation.Seminars in Cutaneous Medicine and Surgery 01/2000; 18(4):257-73. · 2.36 Impact Factor
Article: Lichtdermatosen im Kindesalter[Show abstract] [Hide abstract]
ABSTRACT: Zusammenfassung Die Dermatitis solaris sowie phototoxische und idiopathische Photodermatosen treten im Kindesalter relativ hufig auf. Wesentlich seltener werden auf Enzym- oder Gendefekte beruhende Lichtdermatosen diagnostiziert, und Photoallergien sowie Erkrankungen aus der Gruppe der chronisch-aktinischen Dermatitiden wurden bisher nicht beschrieben. Da eine besondere Lichtempfindlichkeit der Haut bei Kindern oft das erste klinisch manifeste Symptom einer Photodermatose ist, sollte eine frhzeitige diagnostische Abklrung angestrebt werden. Die Diagnose ist oft schwierig zu stellen, da die Lsionen zum Zeitpunkt der Vorstellung des Patienten nur sehr diskret ausgeprgt oder bereits abgeheilt sind. Deshalb kommt den Photoprovokationstestungen gerade im Kindesalter eine besondere Bedeutung in der Diagnostik von Photodermatosen zu. Neben der frhzeitigen Diagnose und konsequenten Therapie ist vor allem die rechtzeitige Aufklrung der Eltern wichtig, damit sie ihre Kinder konsequent vor bermiger UV-Exposition schtzen und so aktinische Sptschden bis hin zu Malignomen vermieden werden knnen. Abstract Actinic dermatitis and phototoxic and idiopathic photodermatoses occur relatively often during childhood. Photodermatoses stemming from enzyme defects and genetic disorders are much less common, while photoallergic and chronic actinic dermatitis have not been dealt with to date. A specific sensitivity of a child's skin to light is often the first manifest clinical symptom of a photodermatosis, the key is to ensure early diagnosis. However, it is often difficult to reach a diagnosis, as the lesions are barely perceptible or have even healed by the time the patient is examined. This is why photoprovocation tests are so important in diagnosing photodermatoses, particularly during childhood. In addition to early diagnosis of these illnesses and offering the appropriate treatment, it is also crucial that the parents be well informed and aware of what symptoms to look for so that they can protect their children from overexposure to UV light and thereby avoid later actinic injuries that can become as serious as malignancies.Der Hautarzt 12/2002; 54(1):25-32. · 0.50 Impact Factor