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Chapter 37: Chronic Actinic Dermatitis

INTRODUCTION

KEY POINTS

  • Chronic actinic dermatitis presents with a well-demarcated eczematous dermatitis consisting of scaly, pruritic patches and plaques confined to the head and neck.

  • In lighter skin, this can vary from pink to red erythema, while in darker skin, it can be pink-brown to violaceous to brown-black.

image

FIGURE 37-1.

Pink-tan scaly lichenified patches and plaques on face, ear, neck, and scalp. Note the sparing of the neck fold. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 95-2A.)

A photo shows severe ultraviolet and light-induced eczema of the face and neck. The lesions are eczematous, confluent, and appear white and scaly.
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FIGURE 37-2.

Violaceous-brown patches on the lateral cheek, ear, and posterior neck with background postinflammatory hyperpigmentation from chronic actinic dermatitis in a Black male. (Reproduced with permission from Silpa-Archa N, Kohli I, Chaowattanapanit S, et al. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591-605.)

A patient with dark-colored skin exhibits hyperpigmented black patches on the left ear and the surrounding regions.
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FIGURE 37-3.

Diffuse erythema and edema on the face with visible infiltrated skin-colored plaques on the chin. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 95-1.)

The image shows a photograph depicting chronic actinic dermatitis with infiltrated eczematous eruption on the face.
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