Some researchers theorize the Epstein-Barr virus could play a role in its etiology.13 This sun sensitivity-related reaction occurs in childhood, commonly between the ages of 3 to 15. Clinical features include scarring bullae and vesicles to appear on sun exposed skin, frequently on the face and hands. The disease course begins with edematous papules and vesicles that crust and heal with varioliform scar formation, seen in figure 4.13 Diagnosis is made clinically or with biopsy showing intraepidermal reticular degeneration and cell necrosis. Some cases have documented ocular involvement including conjunctivitis, corneal involvement, and keratouveitis. 14 This disease frequently resolves spontaneously at the end of adolescence, but the scars and possible mutilations from the lesions remain permanently.13 Prevention includes sun avoidance or mechanical sun protection, such as sunscreen and sun-protective clothing.13,14 Phototherapy used at least three times a week in the spring can help induce the hardening phenomenon. Anti-malarial drugs including chloroquine and hydroxychloroquine have been known to suppress lesions associated with many photodermatoses and can be used to benefit some patients.13 Because of the possibility for severe scarring and for more widespread symptoms, hydroa vacciniforme should be treated …show more content…
The skin reaction that manifests in this disease are thought to be associated with HLA gene. 3,15 This disease develops in childhood and symptoms present as intensely pruritic lesions on the face, neck, ears, and dorsal arms. (Figure 5) Lichenification is eventually seen, due to chronic scratching.1 Actinic prurigo can be differentiated between PMLE because it lasts longer and is more pruritic than PMLE. Cheilitis is a common associated symptom, appearing in 65% of affected patients.3 Thalidomide is a immunomodulatory drug that can be used in some individuals to treat actinic prurigo. However, caution must be maintained due to cases of severe adverse drug reactions.1,15 Antihistamines can also be used to help relieve pruritus.1 Actinic prurigo can be a difficult disease due to its most common age group affected. Children commonly have a challenging time due to the intensely pruritic