Diagnosis and pharmacological treatment of chronic actinic dermatitis in the elderly: an update.

Chronic actinic dermatitis (CAD) describes a condition resulting from abnormal photosensitivity; the dermatitis is clinically similar to contact allergic dermatitis. Sun-exposed skin is more commonly affected but the condition can extend to and encompass unexposed skin. CAD is relatively rare but becomes more prevalent in the elderly population. Phototesting, patch testing and laboratory results should be used to help guide diagnosis. In the elderly, it is important to distinguish CAD from drug-induced photosensitivity. Management of the condition requires sunlight avoidance and use of sunscreens, topical emollients and topical corticosteroids. Oral corticosteroids and immunosuppressive therapy such as azathioprine may be indicated but should be used with caution in the elderly.