To the Editor.—
We read with interest the article entitled Management of Chronic Photosensitive Eczema1 and would like to make a number of observations.Our experience with this condition, which comes within the spectrum of photosensitivity dermatitis/actinic reticuloid syndrome otherwise known as chronic actinic dermatitis, is that it is essentially a diagnosis of exclusion. Within the group of middle-aged to elderly men particulary affected, the use of thiazide diuretics is a common occurrence and, in the majority of cases, the drug is playing no role in the photosensitivity with the condition following the same pattern as non-thiazide-taking patients. In this group as a whole the finding of multiple contact allergy to a range of materials, including fragrances and compositae,2,3 provides a useful management opportunity and careful avoidance of these agents, along with the use of broad-spectrum photoprotective agents, may enable a patient to not only enter clinical
Bilsland D, Ferguson J. Management of Chronic Photosensitive Eczema. Arch Dermatol. 1991;127(7):1065–1066. doi:10.1001/archderm.1991.01680060141027
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