Actinic Prurigo Publications (156)


Actinic Prurigo Publications

J Eur Acad Dermatol Venereol
J Eur Acad Dermatol Venereol 2016 Nov 4;30(11):e140-e142. Epub 2015 Nov 4.
Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.
Am J Dermatopathol
Am J Dermatopathol 2016 Jun;38(6):418-22
*Department of Pathology, Division of Dermatopathology, Medical College of Wisconsin, Milwaukee, WI; †Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico; Departments of ‡Pathology, and §Dermatology, MD Anderson Cancer Center, Houston TX; ¶Hospital General De Mexico, Mexico City, Mexico; ‖Division of Dermatology and Pathology, Hospital Obrero, La Paz, Bolivia; and **Department of Pathology, Dental School, University of Sao Paulo, Sao Paulo, Brazil.

Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. Read More

and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.

Skinmed 2015 Jul-Aug;13(4):287-95; quiz 296. Epub 2015 Aug 1.
Dermatology Department, Hospital General Dr. Manuel Gea González, México DF, Mexico.

Actinic prurigo is an idiopathic photodermatosis that affects the skin, as well as the labial and conjunctival mucosa in indigenous and mestizo populations of Latin America. It starts predominantly in childhood, has a chronic course, and is exacerbated with solar exposure. Little is known of its pathophysiology, including the known mechanisms of the participation of HLA-DR4 and an abnormal immunologic response with increase of T CD4+ lymphocytes. Read More

The presence of IgE, eosinophils, and mast cells suggests that it is a hypersensitivity reaction (likely type IVa or b). The diagnosis is clinical, and the presence of lymphoid follicles in the mucosal histopathologic study of mucosa is pathognomonic. The best available treatment to date is thalidomide, despite its secondary effects.

Br. J. Dermatol.
Br J Dermatol 2016 Jun 30;174(6):1411-4. Epub 2016 Mar 30.
Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital & Medical School, Dundee, DD1 9SY, U.K.
Med Oral Patol Oral Cir Bucal
Med Oral Patol Oral Cir Bucal 2016 Jan 1;21(1):e53-8. Epub 2016 Jan 1.
Department of Dermatology, Dr. Manuel Gea González General Hospital, Calzada de Tlalpan 4800, Sección XVI Delegación Tlalpan, México, D.F. C.P 14080,
J. Am. Acad. Dermatol.
J Am Acad Dermatol 2016 Feb 11;74(2):363-9. Epub 2015 Nov 11.
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address:

Pruritus is a common and often times difficult to treat symptom in many dermatologic and systemic diseases. For pruritus with an inflammatory or autoimmune origin, therapies such as topical corticosteroids and antihistamines are often initiated. However, in the case that these and additional systemic therapies are ineffective, thalidomide, an immunomodulator and neuromodulator, may be a useful alternative treatment. Read More

Considerable relief of chronic pruritus has been demonstrated with thalidomide in case reports, case series, and controlled trials. Double-blind controlled studies demonstrated thalidomide's efficacy as an antipruritic agent in patients with uremic pruritus, primary biliary cirrhosis, and prurigo nodularis. In case reports, case series, and open-label trials, thalidomide significantly reduced pruritus associated with conditions such as actinic prurigo and paraneoplastic pruritus. Because of variations in study design and evaluation of antipruritic effect, it is difficult to fully understand thalidomide's role based on the evidence described to date in the medical literature. In this review, we provide an overview of the reported findings and evaluate thalidomide's utility in managing refractory pruritus in the context of its adverse risk profile. We propose that thalidomide can be an alternative or combination antipruritic treatment for patients who do not obtain enough relief from conservative therapy.