Surgical management of chronic actinic dermatitis

SummaryChronic actinic dermatitis (CAD) is a persistent, ultraviolet (UV) radiation-induced eczema by either UVA, UVB or visible light. We present the case of a 48-year-old woman suffering from severe CAD. Various therapeutic approaches, including topical and local corticosteroids and other systemic immunosuppressives, were used without success, making surgical treatment the only option. Two sessions of manual dermabrasion were necessary to improve the cutaneous disorder. We document the successful treatment of a severe case of CAD with dermabrasion.Chronic actinic dermatitis (CAD) describes a serious and persistent photoinduced skin disorder. It is usually characterised by a perennial, chronic dermatitis that predominantly affects sun-exposed sites, but may also affect shaded sites or even present as erythroderma. Daily application of sun protection has to be combined with topical and local corticosteroids and other systemic immunosuppressives. However, these various therapeutic regimens are often limited by severe side-effects and consecutive failure of therapy. [Dawe RS, Ferguson J. Diagnosis and treatment of chronic actinic dermatitis. Dermatol Ther 2003;16:45–51 [review], Hawk JL, Magnus IA. Chronic actinic dermatitis: an idiopathic photosensitivity syndrome including actinic reticuloid and photosensitive eczema [proceedings]. Br J Dermatol 1979;101(Suppl. 17):24.]