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The physiological role of α‐melanocyte stimulating hormone in regulating integumental pigmentation of many vertebrate species has been recognized since the 1960's. However, its physiological significance for human pigmentation remained enigmatic until the 1990's. α‐Melanocyte stimulating hormone and related melanocortins are synthesized locally in the skin, primarily by keratinocytes, in addition to the pituitary gland, and therefore act as paracrine factors for melanocytes. Human melanocytes express the melanocortin 1 receptor, which recognizes α‐melanocyte stimulating hormone and the related adrenocorticotropic hormone as agonists. This review summarizes the current knowledge of the pleotropic effects of the activated melanocortin 1 receptor that maintain human melanocyte homeostasis by regulating melanogenesis and the response to environmental stressors, mainly solar radiation. Certain allelic variants of the melanocortin 1 receptor gene are associated with specific pigmentary phenotypes in various human populations. Variants associated with red hair phenotype compromise the function of the encoded receptor. Activation of the human melanocortin 1 receptor regulates eumelanin synthesis and enhances DNA damage response of melanocytes to solar radiation and oxidative stressors. We describe how synthetic selective melanocortin 1 receptor agonists can be efficacious as sunless tanning agents, for treatment of vitiligo and photosensitivity disorders, and for prevention of skin cancer, including melanoma. [ABSTRACT FROM AUTHOR]

Mogamulizumab is a first‐in‐class IgG1k monoclonal antibody that selectively targets the chemokine receptor type 4. The drug has received Food and Drug administration authorisation for mycosis fungoides and Sézary syndrome following failure of at least one previous course of systemic therapy and now is available in Europe. One of the most common treatment‐related side effects observed has been the mogamulizumab‐associated rash (MAR), which affects up to a quarter of patients and is the most frequent adverse event leading to drug discontinuation. The aim of this study is to perform a systematic review of the literature on patients diagnosed with MAR and other mogamulizumab‐related cutaneous events to describe the clinical and histological characteristics, the management in clinical practice and to assess whether these events have prognostic implications. In total, 2073 records were initially identified through a literature search, 843 of which were duplicates. After screening for eligibility and inclusion criteria, 49 articles reporting mogamulizumab‐associated cutaneous events were included. Totally, 1516 patients were retrieved, with a slight male prevalence as for the available data (639 males and 570 females, i.e. 52.9% vs. 47.1%). Regarding the reported clinicopathological findings of the cutaneous reactions, the five most common patterns were spongiotic/psoriasiform dermatitis (22%), eruptions characterized by the presence of papules and/or plaques (16.1%), cutaneous granulomatosis (11.4%), morbilliform or erythrodermic dermatitis (9.4%) and photodermatitis (7.1%). Our results highlight how the majority of the reported cutaneous adverse events on mogamulizumab are of mild‐to‐moderate entity and generally manageable in clinical practice, though prompt recognition is essential and case‐by‐case assessment should be recommended. Future research will need to focus on the MAR prognostic implications and to identify genomic and molecular markers for a more rapid and accurate diagnosis. [ABSTRACT FROM AUTHOR]

The congenital photosensitivity disorders present as cutaneous signs and symptoms secondary to photosensitivity, extracutaneous manifestations, and a predisposition to malignancy. Diagnosis of these conditions mainly depend on clinical findings as the molecular analysis is not always feasible. A review of all the related articles collected after a thorough literature search using keywords, "congenital AND photosensitivity NOT acquired" and the individual diseases was done. A total of 264 articles were included in the review. An algorithm for diagnosis of the different congenital photosensitivity disorders based on the various clinical presentations has been proposed. An early suspicion and diagnosis of the different congenital photosensitivity disorders is the cornerstone behind prompt institution of prevention and treatment, and decreasing the associated morbidity. [ABSTRACT FROM AUTHOR]

Macrolides and tetracyclines are antibiotics that have a range of anti‐inflammatory properties beyond their microbial capabilities. Although these antibiotics have been in widespread use, the long‐term safety profiles are limited. We performed a systematic review and meta‐analysis of randomized clinical trials that compared macrolides or tetracyclines with placeboes to provide long‐term safety information. We searched Medline and EMBASE from inception to October 2022 and identified studies that reported study drug‐related death, serious adverse events (SAEs), or withdrawal rates, and common adverse effects of each drug. Relative risk (RR) and number needed to harm were calculated. Of the 52 randomized clinical trials included, there are 3151 participants on doxycycline, 2519 participants on minocycline, 3049 participants on azithromycin, 763 participants on clarithromycin, 262 participants on erythromycin, and 100 participants on roxithromycin. There was no death related to any study drugs and rates of SAE were not significantly different from placebo in any drug. Overall withdrawal rates were slightly higher than placebo in doxycycline (RR, 1.30; 95% CI, 1.12‐1.52) and minocycline (RR, 1.29; 95% CI, 1.15‐1.46). Withdrawal rates due to adverse events were higher in doxycycline (RR, 2.82; 95% CI, 1.88‐4.22), minocycline (RR, 1.48; 95% CI, 1.09‐1.98), and azithromycin (RR, 1.53; 95% CI, 1.13‐2.08). Gastrointestinal disturbances are the most common tolerable adverse effects for every drug. Photosensitivity and rash are the second most common adverse effects for doxycycline and minocycline. We found no evidence that long‐term use up to 2 years of macrolides or tetracyclines was associated with increased risk of SAEs. [ABSTRACT FROM AUTHOR]

This article presents a case report of a 75-year-old Japanese male who developed depigmented contact dermatitis after using a skin lotion containing phenylbenzimidazole sulfonic acid. The patient experienced discomfort and skin symptoms after using the lotion, which subsided but left behind depigmented spots. Patch tests confirmed an allergic contact dermatitis reaction to phenylbenzimidazole sulfonic acid. The article highlights the possibility of depigmentation due to inflammation at the epidermal-dermal interface and emphasizes the importance of considering this phenomenon in cases of contact allergy to this substance. [Extracted from the article]

Objective: Photosensitivity is one of the most common manifestations of systemic lupus erythematosus (SLE), yet its pathogenesis is not well understood. The normal‐appearing epidermis of patients with SLE exhibits increased ultraviolet B (UVB)–driven cell death that persists in cell culture. Here, we investigated the role of epigenetic modification and Hippo signaling in enhanced UVB‐induced apoptosis seen in SLE keratinocytes. Methods: We analyzed DNA methylation in cultured keratinocytes from SLE patients compared to keratinocytes from healthy controls (n = 6/group). Protein expression was validated in cultured keratinocytes using immunoblotting and immunofluorescence. An immortalized keratinocyte line overexpressing WWC1 was generated via lentiviral vector. WWC1‐driven changes were inhibited using a large tumor suppressor kinase 1/2 (LATS1/2) inhibitor (TRULI) and small interfering RNA (siRNA). The interaction between the Yes‐associated protein (YAP) and the transcriptional enhancer associate domain (TEAD) was inhibited by overexpression of an N/TERT cell line expressing a tetracycline‐inducible green fluorescent protein–tagged protein that inhibits YAP–TEAD binding (TEADi). Apoptosis was assessed using cleaved caspase 3/7 and TUNEL staining. Results: Hippo signaling was the top differentially methylated pathway in SLE versus control keratinocytes. SLE keratinocytes (n = 6) showed significant hypomethylation (Δβ = −0.153) and thus overexpression of the Hippo regulator WWC1 (P = 0.002). WWC1 overexpression increased LATS1/2 kinase activation, leading to YAP cytoplasmic retention and altered proapoptotic transcription in SLE keratinocytes. Accordingly, UVB‐mediated apoptosis in keratinocytes could be enhanced by WWC1 overexpression or YAP–TEAD inhibition, mimicking SLE keratinocytes. Importantly, inhibition of LATS1/2 with either the chemical inhibitor TRULI or siRNA effectively eliminated enhanced UVB‐apoptosis in SLE keratinocytes. Conclusion: Our work unravels a novel driver of photosensitivity in SLE: overactive Hippo signaling in SLE keratinocytes restricts YAP transcriptional activity, leading to shifts that promote UVB apoptosis. [ABSTRACT FROM AUTHOR]

Background/Purpose: Chronic actinic dermatitis (CAD) is a spectrum of diseases with chronic photosensitivity occurring mostly among middle‐aged and older men. We seek to explore the characteristics and pathogenesis of CAD among the Chinese population. Methods: The medical records of 488 CAD cases diagnosed by phototesting at Huashan Hospital, Fudan University from January 2014 to December 2018 were analyzed retrospectively. Results: Among the 488 patients, 344 were male and 144 were female. 84.8% of the cases were over 40 years old at the age of onset, while the remaining with an early age of onset had a prevalence of atopic history of 21.6%. Up to 45.0% of the patients reported excessive sun exposure and outdoor activities before the initiation of symptoms. The typical skin lesions were erythema, papules and plaques laid predominantly in sun‐exposed areas. 42.8% of the cases showed sensitivity to UVB only, 20.7% were both sensitive to UVA and UVB, and 18.2% had UVA sensitivity only. The most predominant photoallergens were chlorpromazine (80.1%), thimerosal (17.2%), potassium dichromate (12.7%), etc. The most prevalent patch test allergens were potassium dichromate (24.4%), thimerosal (20.5%), formaldehyde (16.8%), etc. Conclusions: CAD was more commonly seen in males over 40 years old. The action spectrum of Chinese patients is primarily in the UVB range. Exposure to excessive sunlight or contact allergens and photoallergens are important risk factors. Photobiology tests are essential in detecting photosensitivity and recognizing potential photosensitizers. Early avoidance of confirmed photoallergens and sun exposure may prevent photosensitive reactions from progressing into persistent photosensitivity. [ABSTRACT FROM AUTHOR]

Two siblings presented with sun sensitivity and progressive dyspigmentation. A diagnosis of xeroderma pigmentosum was initially favored due to XPC mutations, although variants were not clearly diagnostic. However, new moderate neutropenia and homozygous suspected pathogenic variants in USB1 led to diagnosis of poikiloderma with neutropenia. This case highlights the importance of reevaluation of diagnosis due to significant phenotypic overlap in congenital disorders of photosensitivity with poikiloderma or dyspigmentation. [ABSTRACT FROM AUTHOR]

Solar urticaria is a rare, immunologically mediated photodermatosis in which activation of cutaneous mast cells is triggered by specific wavelengths of solar electromagnetic radiation. This manifests clinically as the rapid development of cutaneous itch, erythema and wheal formation after several minutes of sun exposure. Disease mechanisms in solar urticaria remain incompletely elucidated and there have been few recent investigations of its pathobiology. Historic passive transfer experiments performed during the twentieth century provide support for a 'photoallergy' model of disease pathogenesis, wherein molecular alteration of a putative chromophore by solar electromagnetic radiation produces mast cell activation via an IgE‐dependent mechanism. However, this model does not account for several observations made during passive transfer experiments nor does it explain a range of subsequent clinical and photobiological observations made in solar urticaria patients. Furthermore, increased understanding of the molecular dynamics underpinning cutaneous mast cell responses highlights the need to reformulate our understanding of solar urticaria pathogenesis in the context of this contemporary scientific landscape. In this review, we discuss the current understanding of solar urticaria pathogenesis and, by incorporating recent scientific and clinical observations, develop new hypotheses to drive future investigation into this intriguing disorder. [ABSTRACT FROM AUTHOR]

Background/Purpose: Tricyclic antidepressants (TCAs) are still widely used and are available to purchase without prescription in some countries. Awareness of adverse cutaneous drug reactions is essential. Method: We reported a case of photo‐distributed hyperpigmentation due to imipramine and carried out a systematic search of the related articles using the search terms "tricyclic antidepressants" or "tricyclic antidepressive agents", and "hyperpigmentation" or "photosensitivity disorder". Fifty non‐duplicate citations were identified of which 28 articles which were independently assessed in full. The review was registered in PROSPERO, CRD42018107338. Results: The remaining 25 articles met our inclusion criteria. Photo‐distributed hyperpigmentation tricyclic antidepressant‐induced photosensitivity reactions (TIPs) was the most common presentation. In 21 cases, this presented as an asymptomatic discolouration of exposed sites. Imipramine (81%), amitriptyline (9.5%), desipramine hydrochloride (4.8%) and mirtazapine (4.8%) were reported to be the culprit drugs. Nineteen were female with a mean age at presentation of 55 years. Mean duration from commencing the culprit drug until the development of discolouration was 10.4 years. Mean daily dose was 222.7 mg for imipramine. Histology was characteristic with golden‐brown or brownish granules deposited in dermis. Staining for Masson‐Fontana and MEL‐5 was positive in all cases. Phototesting had not been done in cases prior to ours (negative 3 months after discontinuation of imipramine). Three further reports of suspected TIP presented with non‐specific and eczematous eruption. The two presentations were reported along with systemic problems (thrombocytopenia and hepatic injury). Conclusions: This systematic review highlights the characteristic features of exposed site hyperpigmentation of TCA‐induced photosensitivity occurring after prolonged drug exposure in many cases. [ABSTRACT FROM AUTHOR]

Background: Photodermatoses are sun‐related inflammatory skin diseases. They usually require phototesting in diagnosis. However, fewer and fewer medical centers in France are equipped with photobiological equipment. Objectives: The main purpose was to evaluate the relevance of phototesting in photodermatosis diagnosis. The second goal was to study the proportions of the different kinds of photodermatosis found in this particular study. Methods: This study was descriptive, retrospective, and mono‐centric. It was based on 100 consecutive patients, who have been phototested in a French University Hospital from 2014 to 2018. Phototesting included determination of the minimal erythematous dose (MED), UVA and UVB phototests, and photopatch testing. Results: The use of phototesting led to 60% of photodermatosis diagnosis and formally eliminated the latter in 13% of the cases. The diagnosis remained undetermined in 27% of the cases. Nineteen cases of polymorphous light eruption (PLE), 14 cases of photocontact dermatitis (PCD), 10 cases of solar urticaria, 8 cases of photo‐aggravated atopic eczema, 5 cases of chronic actinic dermatitis, and 2 cases of systemic photosensitization were diagnosed. The allergens involved in PCD were topical non‐steroidal anti‐inflammatory drug (NSAID) in 9 cases, sunscreens in 3 cases, and fragrance in 2 cases. The average amount of time between the first symptoms and actual phototesting was about 7,5 years. Conclusion: This study confirms phototesting is truly useful. PLE was the most common form of photodermatosis, followed by PCD and solar urticaria. As photodermatosis could imply severe diseases sometimes requiring hospitalization, it is critical to maintain this expertise. [ABSTRACT FROM AUTHOR]

Background: Photodiagnostic investigations are essential for the accurate diagnosis of abnormal cutaneous photosensitivity and provide important information for the management of patients with photodermatoses (cutaneous photosensitivity disorders). Although photodiagnosis has been undertaken since the early 1970s, specialist services in the United Kingdom (UK) and Republic of Ireland are limited and there is no formal guidance on diagnostic approach. Indeed, there is a limited literature in this area of methodology and diagnostic practice. Objectives: The primary objective was to undertake a British Photodermatology Group Workshop to review the role and activities of specialist centres in the UK and Republic of Ireland in order to ascertain whether there were consensus practices. Secondary objectives were to identify key priorities for service, training and research. Methods: An initial detailed survey review of current activities was undertaken prior to the Workshop and data from this survey were used to inform discussion at the Workshop, which was attended by key photodermatology experts from the UK and Republic of Ireland. Results/Conclusions: We have undertaken a detailed review of current Photodiagnostic Services in the UK and Republic of Ireland and report on our findings from the 12 centres and we have identified key areas of consensus practice. This is an important step in the process of standardising and optimising procedures and protocols and defining minimum clinical standards for photodiagnostic investigations, which are of such diagnostic importance in Dermatology. [ABSTRACT FROM AUTHOR]

Objective: Benzodiazepines have been reported to cause photosensitivity reactions. We characterized the clinical presentation and diagnosis of benzodiazepine‐associated photosensitivity and adjudicated these cases for a causal association with benzodiazepines. Methods: A literature search on PubMed's "MeSH" search feature and CINAHL (1964 to 2019) was performed using search terms: benzodiazepine, photosensitivity, and photosensitivity disorders/chemically induced. We applied the Naranjo scale, a standardized causality assessment algorithm, to identified cases. Results: We identified eight published cases, with 50% of patients being female with a mean age of 46.3 years. Alprazolam, tetrazepam, clobazam, and clorazepate induced phototoxic reactions. Chlordiazepoxide induced one photoallergic reaction. Photosensitivity occurred between 1‐3 days (37.5%), 7‐14 days (25%), and >14 days (25%). Photosensitivity resolved after drug discontinuation within 2 weeks (62.5%). Benzodiazepine rechallenge confirmed photosensitivity in 75% of cases. Photopatch testing was negative in two patients; however, these patients had positive oral provocation testing. However, an oral photoprovocation test, an ideal diagnostic test, was not administered to several patients. Despite these challenges, the Naranjo scale identified 5 cases as definite benzodiazepine‐induced photosensitivity. Conclusion: Five benzodiazepines induced photosensitivity reactions. Five patients showed a definite association with the Naranjo scale. Reporting to pharmacovigilance databases may help identify other benzodiazepines causing photosensitivity reactions. [ABSTRACT FROM AUTHOR]

Background: Cutaneous exposure to sunlight is a major source of vitamin D. Individuals with photosensitivity disorders have symptoms provoked by sunlight and may not achieve the brief sunlight exposures that convey vitamin D acquisition. Objective: To explore knowledge, behaviour and attitudes towards vitamin D and its acquisition in patients with photosensitivity. Methods: Patients (n = 19) diagnosed with solar urticaria, erythropoietic protoporphyria or polymorphic light eruption at a specialist photoinvestigation centre participated in semi‐structured focus groups to discuss vitamin D knowledge, acquisition behaviours and attitudes towards vitamin D acquisition through sunlight and diet. Discussions were analysed by thematic analysis using MAXQDA11. Results: Knowledge of vitamin D was variable. There was good awareness that sunlight exposure is an important source but knowledge of dietary sources was poor. Patients had little concern for their own vitamin D status prior to attending the photoinvestigation centre. Most patients avoided sunlight exposure, were unable to achieve the guidance on sun exposure for healthy individuals and were aware this could affect their vitamin D status. Use of oral vitamin D supplements was common, and all were willing to consider supplements if required. Patients recommended improving education of clinicians to increase patient awareness of vitamin D, Conclusions: More targeted guidance is required on acquisition of vitamin D for patients with photosensitivity, supported by increased patient and clinician education. [ABSTRACT FROM AUTHOR]

Background: In Europe, contact photosensitivity to phenothiazines is well‐known, particularly in southern countries. Topical phenothiazines are widely used and sold over‐the‐counter (OTC) for the treatment of mosquito bites and pruritus in France. Objective: To report a series of cases with photodermatitis following use of topical phenothiazines. Method: A retrospective study of cases of contact dermatitis from phenothiazines seen in French photodermatology centers was performed. Results: In all, 14 patients with a diagnosis of contact dermatitis from phenothiazines were included. These patients developed eczema on the application sites, and in 13 the eruption spread to photodistributed sites. Topical products containing isothipendyl were the most common cause of photodermatitis. One patient had photoaggravated eczema due to promethazine cream. All patients stopped using topical phenothiazines and were treated successfully with topical corticosteroids. One patient relapsed and developed persistent light eruption. In all of the nine cases tested, photopatch testing to the topical phenothiazine used "as is" was positive. Isothipendyl, chlorproethazine, and the excipients were not tested. Photopatch tests to chlorpromazine and promethazine were positive in 8 of 12 and 7 of 13 tested, respectively. Conclusion: Use of isothipendyl and promethazine as OTC (or even prescribed) drugs needs to be limited due to severe reactions and sensitization to other phenothiazines that consequently will have to be avoided. [ABSTRACT FROM AUTHOR]

Background: Phototesting is part of the standard procedure for the evaluation of patients with photosensitivity disorders. The response of patients to targeted UVB or UVA radiation helps to find out more about the nature of photodermatosis. Nevertheless, there are no default values of the minimal erythema dose (MED). Methods: This study evaluated data of 203 patients (131 female, 72 male, mean age 52 years) who were referred for phototesting to the University Hospital Zurich between 2012 and 2017. We retrospectively analyzed the demographic data, medical history, skin phototype, reaction to UVB and UVA radiation, and, if present, the diagnosis of photodermatosis. In patients who did not develop erythema at the highest tested UV doses, the next logical increment was taken for analysis. In case of UVA, the two periphery doses could not be evaluated due to technical issues, so the closest reliable UVA doses were used. Results: The MED‐UVB correlated with the skin type and increased with a higher phototype. No such correlation could be seen for MED‐UVA. However, the MED‐UVA was significantly reduced in patients with photodermatosis without significant differences between the subgroups of photodermatosis. More than half of the patients did not show a reduced MED despite a diagnosed photodermatosis. Conclusion: We showed, how different skin types with and without photodermatosis react to UV radiation. Based on the results, we suggested threshold doses that can be chosen for phototesting, presented which doses can be considered pathologic and showed the probability of a pathologic MED in correlation with a diagnosed photodermatosis. [ABSTRACT FROM AUTHOR]

Keywords: dystrophic xanthomization; frontal fibrosing alopecia; lichen planus pigmentosus; xanthoma EN dystrophic xanthomization frontal fibrosing alopecia lichen planus pigmentosus xanthoma 7251 7252 2 12/30/22 20221201 NES 221201 To the Editor, Frontal fibrosing alopecia (FFA) is nowadays the most frequent type of scarring alopecia and it is associated with other clinical signs such as facial papules, glabellar red dots, frontal veins depression, or liquen planus pigmentosus (LPPigm).[1] Dystrophic xanthomization is a process that corresponds to the accumulation of lipid-rich foam cells within an area of damaged skin. We report the case of a patient with facial LPPigm associated with FFA that secondarily developed dystrophic xanthomas over the areas of LPPigm. [Extracted from the article]

Keywords: photosensitivity disorders; thalidomide; therapeutics EN photosensitivity disorders thalidomide therapeutics 493 495 3 11/16/20 20201101 NES 201101 INTRODUCTION Chronic actinic dermatitis (CAD) is a rare, severe, and often disabling photodermatitis.1 In recalcitrant cases, conventional treatments based on photoprotection, topical steroids, and immunosuppressive agents are disappointing.2 We herein report a case of recalcitrant CAD successfully treated with thalidomide. Photosensitivity disorders, thalidomide, therapeutics. [Extracted from the article]

Keywords: case report; cheilitis; benzydamine hydrochloride; mouthwash, photoallergy; photopatch test EN case report cheilitis benzydamine hydrochloride mouthwash, photoallergy photopatch test 130 132 3 07/27/20 20200801 NES 200801 Benzydamine (CAS no. 642-72-8), available as hydrochloride salt [1-benzyl-3-(3-diethylaminopropoxy)-1H-indazole hydrochloride], is a non-steroidal anti-inflammatory drug systemically and locally used in odontostomatology, otorhinolaryngology, orthopaedics, urology, and gynaecology for its anaesthetic, analgesic, and anti-inflammatory properties. It is topically used as cream or gel, as well as vaginal rinse and mouth wash.1 We describe two cases of photocontact cheilitis to benzydamine hydrochloride contained in a mouthwash. [Extracted from the article]

We report a case of a newly recognized primary immunodeficiency due to biallelic mutations in CARMIL2 manifesting as an actinic prurigo‐like photodermatitis, allergic diathesis and recurrent infections in a child. We present this case to highlight a rare phenotype seen in this T‐cell immunodeficiency and provide an overview of other dermatologic manifestations among published reports of this condition. [ABSTRACT FROM AUTHOR]

Photodermatoses represent a heterogeneous collection of disorders unified by the characteristic of being provoked through exposure to ultraviolet radiation. Generally, these conditions are classified into the following categories: immunologically mediated photodermatoses, chemical‐ and drug‐induced photosensitivity, photoaggravated dermatoses and photosensitivity associated with defective DNA repair mechanisms or chromosomal instabilities. The list of photodermatoses is extensive, and each individual photodermatosis is understood to a different extent. Regardless, there exists a paucity of information with regards to the clinical presentation among those with skin of colour. With ever‐changing global demographics, recognition of photosensitive disorders in a diverse population is essential for accurate diagnoses and therapeutic guidance. The scope of this article seeks to review the epidemiology and clinical variability in presentation of such photodermatoses in patients with skin of colour. [ABSTRACT FROM AUTHOR]

Summary: Background: Photoaggravated allergic contact dermatitis caused by methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI has been reported. Objectives: To describe the clinical characteristics and results of (photo)patch tests and photo‐tests of 10 patients in Belgium and France suffering from photoaggravated contact dermatitis caused by MI. Patients and Methods: Five men and five women, with a median age of 49.5 years, were investigated between January 2012 and February 2017 because of suspected photoaggravated contact dermatitis. Patch tests, photopatch tests and/or photo‐tests were performed. Results: Seven patients had positive patch test reactions to both MCI/MI and MI, whereas 3 patients had positive patch test reactions only to MI. In most cases, MI was the (strong) primary sensitizer. Photopatch tests with MCI/MI and/or MI gave stronger reactions than patch tests with these derivatives, indicating photoaggravation. Sensitization probably took place from cosmetics and work‐related biocides, whereas elicitation of dermatitis was remarkably often related to airborne exposure to MI present in paints or industrial biocides. Four patients suffered from transient photosensitivity. Conclusion: Photoaggravated allergic contact dermatitis and transient photosensitivity caused by MI is a peculiar clinical presentation of allergic contact dermatitis caused by this preservative, and should be considered in daily clinical practice. [ABSTRACT FROM AUTHOR]

Abstract: Farnesol, a natural 15‐carbon organic compound, has various microbiological and cellular activities. It has been found to exert apoptosis‐inducing effects against carcinoma cells as well as antiallergic and anti‐inflammatory effects in vivo. In the current study, a series of formulations composed of various concentrations of hydroxypropyl methylcellulose (HPMC) with the addition of hyaluronan (HA) and xanthan gum (XG) was designed to evaluate the UVB‐screening and H2O2‐eliminating effects of farnesol in normal fibroblasts. Farnesol at 0.005, 0.0075, and 0.01% exhibited significant capacity for H2O2 scavenging; at 0.0025%, it showed insignificant effects. Under 120‐min UVB exposure, screening with plural gel composed of 0.0025% farnesol, 0.5% HA, and 0.5% XG containing 1.5% or 2% HPMC retained normal fibroblast viability. After 60‐min exposure to UVB, screening with plural gel composed of farnesol, HA, XG, and 0.5%, 1.0%, 1.5%, or 2% HPMC decreased the ratio of the G1 phase and increased ratio of the S phase in comparison with the accumulated cell cycle of the normal fibroblasts without screening. The gel with 2% HPMC displayed the strongest cell cycle‐reversal ability. In vivo histopathological results showed that the prepared plural gels with 0.5% or 2% HPMC and farnesol, HA, and XG had greater antiphotoaging and reparative effects against UVB‐induced changes and damage in the skin. In conclusion, the current in vitro and in vivo results demonstrated that the prepared plural composed of 0.0025% farnesol, 0.5% HA, 0.5% XG, and 2% HPMC possessed the greatest UVB‐screening capacity and the strongest restorative effects on UVB‐induced sunburned skin. [ABSTRACT FROM AUTHOR]

Summary: Background/purpose: Sunburn and other health risks associated with excess sun exposure place huge economic burdens on societies, and create discomfort and disease within susceptible individuals. Oral supplements that reduce sunburn may be advantageous. This study evaluated the safety and efficacy of Bend Skincare Anti‐Aging Formula to ameliorate sunburn induced with a solar simulator. Methods: Subjects (n = 28) with Fitzpatrick skin phototypes I, II, or III took 4 capsules daily of the supplement providing 1400 mg of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), 120 mg of gamma‐linolenic acid (GLA), 5 mg of lutein, 2.5 mg of zeaxanthin, and 1000 IU of vitamin D3 for 8 weeks. Skin on each subject's back was exposed to a progressive sequence of timed ultraviolet (UV) radiation exposure doses at baseline, and after 4‐ and 8‐week treatment to determine their minimal erythema dose (MED). Results were compared before and after treatment using 3 paired t tests and subsequently 3 linear mixed models. Results: Treatment significantly improved tolerance to UV exposure as evidenced by increased MED at 4 and 8 weeks compared with baseline (P < .001). This protection increased with prolonged use of Bend Skincare Anti‐Aging Formula as demonstrated by progressively increased MED between baseline and 4 weeks, and again between 4 and 8 weeks (P < .001). Nearly 86% of patients responded to treatment within 4 weeks and 100% of patients responded by the end of the study, resulting in a 39% mean increase in MED at 4 weeks, and an 84% mean increase in MED at 8 weeks compared with baseline. Treatment was well tolerated with no product associated adverse events (AE) and only a few mild and expected side effects. Conclusion: Bend Skincare Anti‐Aging Formula safely and effectively provides significant skin photoprotection that increases with continued use. [ABSTRACT FROM AUTHOR]

Summary: Background: Compositae dermatitis was originally described as airborne contact dermatitis. More recent studies have reported a wider clinical spectrum, but often in polysensitized patients. Objective: To evaluate the clinical features of patients sensitized to Compositae only. Patients/Methods: Consecutive Compositae‐sensitive eczema patients, tested between 1990 and 2015, who, at the patch testing session diagnosing their Compositae allergy, were found to be sensitized only to the plant family, were included. Results: Altogether, 529 of 13 139 patients tested (4.0%) were sensitized to Compositae, and 95 (18% of these) were monosensitized. The majority had hand eczema, and 39 (44%) had a vesicular volar pattern. Eighty‐one patients were classified into one of three groups of similar size: localized eczema, eczema of exposed skin, and localized eczema turning into widespread eczema. Conclusions: The prevalence of Compositae sensitization is continuously high in consecutive eczema patients. Sensitization may occur at any age. Clinical features in monosensitized patients vary, but, with continuing exposure, the patients may develop more widespread dermatitis similar to classic Compositae dermatitis. Avoidance may clear the exogenous part, but not endogenous aetiological factors such as vesicular hand eczema or possible photosensitivity. Thorough clinical assessment and patient education are important in reducing the impact of Compositae contact allergy. [ABSTRACT FROM AUTHOR]

Objective: Bee (Apis mellifera L.) venom (BV) has been used as a cosmetic ingredient owing to its anti-aging, anti-inflammatory, and antibacterial effects. The aim of this study was to assess the skin safety of BV. Methods: For this purpose, skin phototoxicity and sensitization tests were conducted in healthy male Hartley guinea pigs. The animals were divided into three groups (n=5) for the phototoxicity test: G1 (negative control), G2 (BV gel treatment), and G3 (positive control). After specified treatments, the animals were irradiated with ultraviolet A (15 J/cm2). The photosensitivity test was also performed in three groups: G4 (negative control, n=5), G5 (BV gel treatment, n=10), and G6 (positive control, n=5). Results: Erythema and edema were observed after 24, 48, and 72 hours in the positive control group, but not in the negative control and BV gel groups. Application of BV to the guinea pig skin had no toxic effects on any clinical signs, body weight, or mortality. In addition, it did not evoke a skin reaction in both either the skin phototoxicity and skin photosensitization tests. Conclusion: Therefore, it can be concluded that BV has the potential to be developed as a drug ingredient for topical uses. [ABSTRACT FROM AUTHOR]

The concentration of furocoumarins, known to induce mutagenesis, carcinogenesis and photodermatitis under UV radiation, is limited by the EU cosmetic regulation in consumer products such as cosmetics, sun protection and bronzing formulations. The bergapten concentration is also limited by the International Fragrance Association. Analytical methods have been proposed for their quantification using high-performance liquid chromatography (HPLC) coupled with UV detection or mass spectrometry with limits of detection (LOD) and quantification (LOQ) in accordance with the regulation. These methods are time and solvent consuming for routine quality control analyses. In this context, simple and fast HPLC methods in one- (1-D) and two- (2-D) dimensions were developed for the simultaneous analysis of the 15 most common furocoumarins reported in Citrus essential oils: psoralen, bergapten, xanthotoxin, isopimpinellin, oxypeucedanin, oxypeucedanin hydrate, byakangelicol, byakangelicin, heraclenin, 8-geranyloxypsoralen, bergamottin, imperatorin, isoimperatorin, phellopterin, epoxybergamottin along with five other furocoumarins known to be present in Angelica, bergamot or Heracleum species: angelicin, bergaptol, isobergapten, psora-4 and 5-(4-phenoxybutoxy)psoralen. The 1-D method was validated for the quantification of bergapten using a Camag TLC Scanner as a detector. The LOD was determined at 2 mg/kg. The method was linear from 2 to 100 mg/kg and the method range was defined using accuracy profiles at with an 80% tolerance interval, with a 30% error, to be 5-100 mg/kg in acetonitrile and 13-100 mg/kg in matrix. [ABSTRACT FROM AUTHOR]

The article presents the case studies of patients with fenofibrate-induced photosensitivity. The patients were suffering from prurituc erythematous papules, scaly patches and papulovesicles. They underwent serology test and skin biosy as well as received intravenous betamethasone for treating skin lesions.

Background and purpose Recent studies have suggested a possible excess risk of skin neoplasms in patients with myotonic dystrophy ( DM). Risk factors related to this observation have not been defined. Method Information regarding personal history of skin tumors, pigmentation phenotype, and skin reaction to sun exposure were collected from 266 DM patients who were enrolled in the US National Institutes of Health National Registry of Myotonic Dystrophy and Facioscapulohumeral Muscular Dystrophy Patients and Family Members. Results Seventy-seven subjects reported having skin tumors that were either benign ( n = 31), malignant ( n = 32) or both ( n = 14). Female gender [odds ratio ( OR) = 2.27, 95% confidence interval ( CI) 1.02-5.05, P = 0.04], older age ( OR = 1.10, 95% CI 1.05-1.16, P < 0.001) and DM1 subtype ( OR = 3.42, 95% CI 1.27-9.26, P = 0.02) were associated with a malignant skin tumor. The associations between malignant skin tumors and known risk factors [light eye color ( OR = 1.62, 95% CI 0.78-3.39, P = 0.20), light skin complexion ( OR = 1.31, 95% CI 0.63-2.73, P = 0.48) and moderate/extensive face freckles ( OR = 1.47, 95% CI 0.50-4.34, P = 0.49)] were modest. Strong, but not statistically significant, associations were noted with sunburn reactions when exposed to sunlight ( OR = 4.28, 95% CI 0.91-19.95, P = 0.06, and OR = 2.19, 95% CI 0.67-7.09, P = 0.19, for sunburn with and without blistering, respectively). Conclusions Although our study was limited by small sample size, the risk factors for malignant skin tumors in DM strongly resemble the general population. It is recommended that DM patients adhere to sun exposure protective behavior. [ABSTRACT FROM AUTHOR]

Objective Photosensitivity is common in patients with systemic lupus erythematosus, although the mechanisms linking ultraviolet (UV) light to flares are not well understood. We undertook this study to determine whether repetitive UVB exposure could induce type I interferon (IFN) production in normal mouse skin, and to investigate the roles of inflammatory monocytes and plasmacytoid dendritic cells (PDCs) in type I IFN production and development of UVB irradiation-induced inflammation. Methods Mice were irradiated with UVB at 100 mJ/cm2 for 5 days, and cutaneous manifestations were examined by messenger RNA expression of inflammatory and type I IFN response genes, histology, and flow cytometry. Inflammatory monocyte and PDC depletion experiments were performed in CCR2-diphtheria toxin receptor (DTR)-transgenic mice and blood dendritic cell antigen 2-DTR-transgenic mice. The roles of type I IFN and of the adaptor protein stimulator of IFN genes (STING) in UVB irradiation-induced inflammation were investigated using IFN-α/β/ω receptor (IFNAR)-knockout mice and STING-knockout mice. Results Repeated UVB irradiation stimulated an inflammatory cell infiltrate and induction of type I IFN and proinflammatory cytokines. Interestingly, the type I IFN response was independent of PDCs but dependent on inflammatory monocytes, which were recruited following UVB irradiation. The adaptor protein STING was necessary for both type I IFN and proinflammatory cytokine expression in the skin. UVB-irradiated IFNAR-knockout mice showed increased levels of proinflammatory genes and more severe inflammation by histology, suggesting a protective role for type I IFN. Conclusion In wild-type mice, repeated doses of UVB irradiation induce monocyte-dependent and PDC-independent expression of type I IFN together with expression of other proinflammatory cytokines. Induction is dependent on the adaptor protein STING. Surprisingly, studies using IFNAR-deficient mice revealed that type I IFN protects against UVB irradiation-induced skin inflammation, in part by attenuating proinflammatory cytokine expression and limiting tissue damage. [ABSTRACT FROM AUTHOR]

The article presents case studies of two boys and a girl with photoallergic contact dermatitis on wrists after they had worn a wristband given by an amusement park in a resort. It notes the extracts of wristband tested with gas chromatography/mass spectrometry, their medical history also including dermatitis due to ketoprofen containing tape.

3 Devleeschouwer V, Roelandts R, Garmyn M, Goossens A. Allergic and photoallergic contact dermatitis from ketoprofen: results of (photo) patch testing and follow-up of 42 patients. Keywords: allergic contact dermatitis; case report; consort dermatitis; ketoprofen; patch test; photo-contact dermatitis EN allergic contact dermatitis case report consort dermatitis ketoprofen patch test photo-contact dermatitis 438 439 2 04/14/22 20220501 NES 220501 CASE REPORT Consort contact dermatitis is an allergic or photoallergic dermatitis caused by sensitizers conveyed by a partner or companion via direct interpersonal skin contact or indirect contact through shared objects.1 We describe a patient who experienced severe bouts of photoallergic contact dermatitis as a result of an indirect contact with topical ketoprofen used by her mother. Allergic contact dermatitis, case report, ketoprofen, patch test, photo-contact dermatitis, consort dermatitis. [Extracted from the article]

Overlap chronic graft-versus-host disease (GVHD) associates both features of acute and chronic GVHD. Trigger factors for chronic GVHD are unclear. We describe two patients who received allogenic haematopoietic stem-cell transplantation, and who later developed overlap chronic GVHD after sun exposure. Available data from in vivo investigations suggest ultraviolet B radiation (UVB) has a beneficial effect on acute and chronic GVHD. The role of sun irradiation as a trigger for isomorphic cutaneous GVHD has been rarely reported in the literature. Herein, we demonstrate for the first time, using repetitive broadband phototesting, that UVB triggers chronic GVHD. [ABSTRACT FROM AUTHOR]

Artificial UV irradiation of murine skin is a frequently used method for testing photosensitivity, study carcinogenesis and photoprotective effects of different compounds. However, doses of UV radiation and mouse strains used in experiments vary greatly. The genetic background of mice may influence the photosensitivity as melanin content, pigmentation and hair cycle parameters are dissimilar. Doses of UV are often expressed in relation to the minimal erythema dose ( MED) that was not necessarily determined for the given strain. We set out to standardize the method of measuring photosensitivity in three commonly used mouse strains, C57 BL/6N, Balb/c and SKH-1. We found that MED may not be determined for some strains as erythema development in mice with diverse genotypes differs greatly. We measured the oedema response in vivo and ex vivo by using OCT. Given the strain-specific variability of erythema, we introduced Clinically Relevant Dose ( CRD) as a new term to replace MED in experiments, to describe the lowest dose that triggers a perceptible skin reaction in mice. Not only the CRD but the proportion of erythema and oedema were different in strains examined. C57 BL/6N mice display skin reactions at the lowest UVB dose, while SKH-1 hairless mice show changes, mostly oedema, after higher doses of UVB. The cellular composition and skin thickness were examined by histopathology. IL-1beta and IL-6 levels in skin correlated with the increasing doses of UVB. Despite the variations in the degree of erythema and oedema, no major differences in cytokine expressions were seen among various strains of mice. [ABSTRACT FROM AUTHOR]

Background Self-reported complaints in people having tattoos, including swelling, itch, and photosensitivity, are frequent. Tattooists are usually heavily tattooed with multiple extended colored tattoos and constitute a specific population of interest. Objectives To assess the prevalence of cutaneous complications on tattoos among a cohort of French tattooists. Methods An observational self-reported internet survey was performed among the tattooists of the French Tattoo Union in November 2013 to report on complaints about their tattoos. Results Of the 448 respondents, 42.6% reported a 'tattoo reaction' on a least one of their previous tattoos: transient itch (45.7%), wax-and-waning swelling (57%), and swelling after sun exposure (23%). A tattoo 'allergy' on one color of the tattoo was found in 8%. Permanent itch, swelling, and cutaneous infection were rare. No skin cancer on tattoos was reported. The binary regression analysis revealed that the area of the tattooed body surface was the main driver of the risk of developing a tattoo reaction, mainly transient or permanent swelling triggered by sun exposure or not. The tattoo reaction, transient itch, and swelling on tattoos seemed to be associated with the sun protection habits of the tattooed individuals. Conclusion Professional tattooists have a high prevalence of minor complaints (transient itch and swelling) and photosensitivity on their tattoos such as in the general tattooed population. [ABSTRACT FROM AUTHOR]

Kindler syndrome is a rare genetic disorder showing some predominant clinical manifestations, for example, trauma-induced blisters, progressive poikiloderma, skin atrophy, and photosensitivity. Oral manifestations are not commonly described and can be often misdiagnosed. This report describes the case of a female patient diagnosed with Kindler syndrome showing the classical clinical features affecting the skin, in addition to oral lesions manifesting as keratotic plaques and ulcers affecting the buccal mucosa, floor of the mouth, alveolar ridge, hard palate, and soft palate. An incisional biopsy was performed to confirm the diagnostic hypothesis of an autoimmune lesion possibly related with the syndrome. Knowledge about the possible manifestations of the Kindler syndrome is important to improve its management. [ABSTRACT FROM AUTHOR]

Guttate hypopigmented macules and flat-topped papules pose a significant diagnostic challenge. Cutaneous examination revealed multiple guttate hypo-to-depigmented atrophic macules and flat-topped papules on the perioral area, bilateral hands, arms, feet, and lower legs (Fig. Keywords: dermoscopy; Lichen Sclerosus et Atrophicus; photosensitivity disorders EN dermoscopy Lichen Sclerosus et Atrophicus photosensitivity disorders 135 136 2 02/24/22 20220201 NES 220201 A 38-year-old woman presented with multiple itchy hypopigmented lesions on the face, upper and lower extremities for six months. [Extracted from the article]

Morphological disintegration of neurons is coupled invariably to neural death. In particular, disruption of outer segments of photoreceptor neurons triggers photoreceptor death regardless of the pathological stressors. We show that Ranbp2 −/− ::Tg-Ranbp2 CLDm-HA mice with mutations in SUMO-binding motif (SBM) of cyclophilin-like domain (CLD) of Ran-binding protein 2 (Ranbp2) expressed in a null Ranbp2 background lack untoward effects in photoreceptors in the absence of light-stress. However, compared to wild type photoreceptors, light-stress elicits profound disintegration of outer segments of Ranbp2 −/− ::Tg-Ranbp2 CLDm-HA with paradoxical age-dependent resistance of photoreceptors to death and genotype-independent activation of caspases. Ranbp2 −/− ::Tg-Ranbp2 CLDm-HA exhibit photoreceptor death-independent changes in ubiquitin–proteasome system (UPS), but death-dependent increase of ubiquitin carrier protein 9(ubc9) levels. Hence, insidious functional impairment of SBM of Ranbp2’s CLD promotes neuroprotection and uncoupling of photoreceptor degeneration and death against phototoxicity. [ABSTRACT FROM AUTHOR]

Clinically, exogenous photosensitizing dermatitis (EPD) includes photocontact dermatitis and actinic drug eruption, and the former can be divided into phototoxic contact dermatitis and photoallergic contact dermatitis.1 Phytophotodermatitis is a common skin lesion mainly caused by acute phototoxic inflammatory reactions.2 However, animal-induced photodermatitis is rare, and cases of bullacto-photodermatitis have been reported in China, but its pathogenesis is still unclear.3 Here we report an unusual case of photodermatitis caused by Mytilus edulis (blue mussel) with edematous erythema as the main manifestation. All data included in this study are available upon request by contact with the corresponding author. [Extracted from the article]

XLP is an erythroid porphyria that results in variable cutaneous photosensitivity due to accumulation of protoporphyrin. The genetic defect in XLP is mutation of the gene ALAS2, resulting in gain of function for the erythroid enzyme 5-aminolevulinate synthase 2. Previous reports have shown that protoporphyrin-induced liver disease may also occur in XLP, occasionally severe enough to warrant liver transplantation; however, transplantation may be followed by injury to the graft due to continued presence of the underlying metabolic disorder in the bone marrow. We present a case of XLP with severe liver disease successfully treated with HPCT to avoid liver transplantation. The case also demonstrates the feasibility of reduced intensity transplant to provide engraftment sufficient for correction of porphyria and tolerability of reduced intensity conditioning containing TLI in the face of severe liver injury. [ABSTRACT FROM AUTHOR]

Aim Chronic migraine is a growing and disabling subtype of migraine with different risk factors and clinical features, even in older adults. We sought to define and differentiate clinical features of chronic migraine in older adults. We also aimed to compare major clinical features of chronic migraine in older adults with those in younger people of both sexes. Methods We used electronic dataset ( Turkish Headache Database) from 13 tertiary headache centers in Turkey. Electronic dataset included detailed headache-defining features according to ICHD-II criteria based on face-to-face interviews and examination by a headache specialist. Using statistical methods, clinical variables of chronic migraine in older adults were compared with those of younger adults. We included 915 patients with chronic migraine (mean age 43.80 ± 13.95 years); 83.3% were females. In total, 301 patients (32.9%) with chronic migraine aged >50 years were compared with 614 patients aged <50 years. Results There was no significant change in men with increasing age. However, duration of headache history, severity of attacks, previous histories of motion sickness and positive family history of headaches were significantly different in women with increasing age. Further sex-related differences have been shown in parameters such as attack duration, quality and associated nausea. Conclusion Chronic migraine is an infrequent type of migraine and shows age-related changes in some phenotypic characteristics, such as severity of attacks, especially in women aged older than 50 years. Furthermore, positive family history of headaches and history of motion sickness increase the likelihood of developing chronic migraine in older women, indicating involvement of some gender-related, but as-yet unknown, genetic factors. Geriatr Gerontol Int 2015; 15: 652-658. [ABSTRACT FROM AUTHOR]

The article describes the case an 11-year-old boy with a history of a rapidly enlarging annular lesion on his cheek, and who was diagnosed with subacute cutaneous lupus erythematosus (SCLE). The diagnosis was confirmed after performing serologic testing and histopathologic evaluation of a skin biopsy. A review of additional cases of SCLE in patients with photosensitivity, rash and pruritic eruption from an institutional electronic database is offered.

BACKGROUND The use of BRAF inhibitors may lead to the development of cutaneous toxicities such as rashes, photosensitivity, alopecia, palmoplantar erythrodysesthesia, and proliferative skin lesions, including keratoacanthomas (KAs) and cutaneous squamous cell carcinomas (cuSCCs). The latter are noteworthy for their potential to exhibit malignant features, and they may necessitate invasive treatment. Their prompt identification is of primary importance for directing supportive care efforts and maintaining dose intensity while minimizing the morbidity associated with supportive care interventions. Because such lesions are less familiar to oncologists, this study was designed to characterize their clinico-morphological features, which have not been hitherto described. METHODS The clinical and dermoscopic characteristics and risk factors of new-onset proliferative skin lesions (benign verrucous lesions and KAs/cuSCCs) developing after the initiation of treatment with vemurafenib, dabrafenib, and XL281 were analyzed; the histopathological diagnoses were ascertained. RESULTS The majority of the lesions were benign verrucous lesions (78%, n = 87), whereas KAs/cuSCCs represented 22% (n = 25). The median times to biopsy for the initial verrucous lesions and KAs/cuSCCs were 4.8 and 10.5 weeks, respectively. The clinico-morphological features significant for KAs/cuSCCs included a larger size ( P < .001), a nodular appearance ( P < .001), a central keratin plug ( P < .001), a central ulceration or crust ( P = .04), an adherent scale ( P = .02), an erythematous halo ( P = .03), and a scaly ring (collarette; P < .001) at the periphery. CONCLUSIONS Our findings represent the first detailed description of the clinico-morphological characteristics that permit distinction between the benign and malignant skin lesions induced by BRAF inhibitors. They are valuable for the recognition of lesions that require intervention and/or a dermatology referral versus those that permit provisional monitoring. Cancer 2015;121:60-68. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

A case study of a 38-year-old HIV-positive woman presented with pruritic, lichenoid, discrete, and coalescing papules and eczematous plaques in various body parts. It mentions the recommendation of using clobetasol propionate, zinc oxide-based sunscreen, and tablet desloratadine, after the patient was clinical diagnosed with photodermatitis possibly from efavirenz.

The article focuses on identification of a novel mutation which confirms phenotypic variability of mutant Xeroderma pigmentosum (XPG) truncations. It mentions XP patients are clinically characterized by increased sun sensitivity, freckling within the sunexposed skin area, and increased incidence of skin cancers. It also mentions cockayne syndrome (CS) considered as a recessive sun-sensitive disorder characterized by photosensitivity, severe growth retardation and cachexia.

Acute photodermatitis provoked by skin contact with giant hogweed ( Heracleum mantegazzianum) and exposure to ultraviolet radiation is a rare cause of phytophotodermatitis in children. We report the case of a 10-year-old girl with extensive photodermatitis after contact with giant hogweed and prolonged exposure to sunlight. The lesions involved 10% of the body surface area, mainly the lower extremities. After initial application of topical steroids to the skin erythema, the topical approach was changed due to extensive bullae. Debridement and temporary wound closure with an adequate dressing was undertaken. This is the first case report of application of Suprathel (PolyMedics Innovations, Denkendorf, Germany) on a phytophototoxic burn-like wound with a favorable outcome. [ABSTRACT FROM AUTHOR]

Background/Purpose Only a few studies have compared frequencies of photodermatoses among different races and skin types. This is an extension of a study performed by Kerr and Lim and evaluates the frequency of photodermatoses in African- Americans compared with Caucasians in the same institution during an 8-year period. Methods Retrospective chart review was performed, including dermatology clinic charts from October 2004 to August 2012 with International Classification of Diseases, Ninth Revision diagnostic codes related to photodermatoses. Results We identified 229 patients with photodermatoses. Of these, 138 (46.6%) were African- American and 63 (42.2%) were Caucasian. Statistically significant differences in the distribution of photodermatoses in African- Americans and Caucasians, respectively, were as follows: phototoxic drug eruption (0.7% and 15.9%, P < 0.0001), phytophotodermatitis (0% and 6.3%, P = 0.009), polymorphous light eruption ( PMLE) (86.2% and 54%, P < 0.0001) and porphyrias (0% and 7.9%, P = 0.003). Conclusion Combined with data from Kerr and Lim, this is the largest study of photodermatoses in African- Americans to date. Congruent to former studies, photodermatoses do occur regularly in dark-skinned individuals. Overall, the frequency of photodermatoses in African- Americans and Caucasians are similar; however, PMLE occurs more commonly in African- Americans, and porphyias and phototoxicity occur more commonly in Caucasians. [ABSTRACT FROM AUTHOR]