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May 2013

Use of Sunlight to Treat Dyshidrotic Eczema

Author Affiliations

Author Affiliation: Department of Biophysics, School of Medicine, University of Belgrade, Belgrade, Republic of Serbia.

JAMA Dermatol. 2013;149(5):634-635. doi:10.1001/jamadermatol.2013.2772

Dyshidrotic eczema is a common complaint. It is very often chronic with recurrences. Although no direct cause of the condition has been identified, immunologic reactions are suggested as a symptom-generating mechanism.1

A 49-year-old white man, employed as a teacher, presented with recurrent dyshidrotic eczema of the palms. During the course of the eczema, 5 dermatologists in 2 institutions treated the condition, and all confirmed the diagnosis. On 3 occasions, mycological examination was performed, and on 1 occasion, the patient underwent epicutaneous testing with European standard series allergens, all with negative results. The eczema was treated over a 3-year period, predominantly with topical corticosteroids. Two recurrences were treated with systemic corticosteroids, and 2 recurrences with psoralen plus UV-A irradiation (PUVA). Each course of therapy was successful resulting in the complete disappearance of dermal changes, but recurrences occurred after every course of therapy. The patient experienced several recurrences of dyshidrotic eczema per year. Exposures to sunlight2 were introduced. Over the next 6 years, the same regimen was followed.

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