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Spotlight On… Chronic actinic dermatitis

by Deen Kurrimbux

A rare chronic skin condition that affects mainly males over the age of 50 although it may occur in younger individuals with atopic dermatitis. Chronic actinic dermatitis (CAD) is a severe form of eczema in which either natural sunlight or artificial light (UV) is the main causal factor, thus individuals with CAD are very sensitive to light. In extreme cases exposure to light in as little as 30 seconds will cause a reaction. The stronger the light, the stronger the reaction.

The main symptoms of CAD are redness and inflammation of the skin along with burning and itching sensations. In some cases the skin will swell up and blister or scale and start peeling. On areas where clothing has partially covered the skin, there can be a sharp contrast between the covered area and the light exposed area. Over time this exposed skin becomes hardened and dry and may peel off. Darkening of the skin may also develop and is more noticeable in people with darker complexions.

Diagnosis of CAD is done by a process called light testing. An area of unexposed skin on the back is subjected to light of differing wavelengths (UVA, UVB and natural sunlight) in order to find out how to best protect the skin. Another test is used to determine whether the individual may be allergic to creams, fibres, fragrances and plant matter.

There is no known cure for CAD but in 10-20% of cases the individual finds the skin condition fades away after a number of years. Photoprotection (protection from the sun) is the best way to prevent further flare ups and longer term complications of CAD. Covering as much of the body with clothing and hoods, hats, visors and gloves are thoroughly recommended. Keeping indoors as much possible with UV blocking protective film on the windows is also recommended. Watching TV or using the computer is safe.

There are a few ways which the symptoms of CAD can be treated. Topical creams and ointments help to reduce the discomfort of the inflammation and itching, they do not, however, cure the inflammation. Another treatment is a type of desensitisation to light: the medical professional applies UV light to the skin in small doses gradually building up tolerances to otherwise risky levels of light. The final treatment available to individuals with severe CAD is immunosuppression: steroid tablets suppress the immune system allowing the body to repair itself. Extreme care must be exercised, however, as the simplest of infections will jeopardise the health and well-being of the individual.

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The prevalence of skin disease exceeds that of obesity, hypertension, or cancer. Despite skin being the largest organ of the human body, dermatological research remains one of the most under funded areas of medicine. In a world where society has an increasing preoccupation with image and it’s importance to every aspect of a person’s life, sufferers of skin diseases are feeling and being more marginalised and isolated than ever.

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