Hydroa vacciniforme is a rare, chronic photosensitivity disorder manifested in childhood by recurrent vesicles that hea1 with srarring. We report a case of hydroa vacciniforme in which vesicles were induced with multiple exposures ta UVA. The clinical features and ap-propriate laboratory evaluation of hydroa vacciniforme are reviewed.
Hydroa Vacciniforme ; Photosensitivity Disorders

Hydroa vacciniforme is a very rare photosensitivity disorder. The primary skin lesion is a vesicle or bulla which then heals with vacciniform scarring. We report a case of hydroa vacciniforme recurred after 3 years period of quiescence in a 20 year-old man who had had history of the disease from the age of two. The duplication of the natural lesion, clinically and histologically, was successfully made by artificial UV-A irradiation on the patient's back.
Cicatrix ; Hydroa Vacciniforme* ; Photosensitivity Disorders ; Skin

Chronic actinic dermatitis is a rare disease worldwide and also in Korea. However there has been no clinicohistologic and photobiological analysis of chronic actinic dermatitis in Korea. We examined 11 patients who were diagnosed as chronic actinic dermatitis and the results of this study were compared with previous reports. Most patients were elderly men who had erythematous papules or lichenified plaques on sun-exposed areas such as the face, neck, and dorsum of the hands with severe itching sensation. All patients had severe sensitivity to UVB and biopsied specimens showed findings of chronic eczema. Five patients had positive photopatch test materials. The patients were treated with systemic and topical steroid, cyclosporine and antihistamine.
Adult ; Aged ; Chronic Disease ; Female ; Human ; Male ; Middle Age ; Photosensitivity Disorders/pathology ; Photosensitivity Disorders/etiology* ; Photosensitivity Disorders/drug therapy ; Ultraviolet Rays/adverse effects

Chronic actinic dermatitis is an uncommon disabling ecxematous photosensitive eruption. The skin lesion is characterized by persistent eczematous eruptions on sun exposed skin with possible extension into nonexposed areas. The phototest shows decreased minimal erythema doses (MED) to UVB and possibly UVA. Histological features demonstrate chronic eczema with or without the presence of lymphoma like changes. The present cases showed pruritic erythematous patches and plaques on sun exposed areas and showed decreased minimal erythema doses to both UVB and UVA. We herein report three cases of chronic actinic dermatitis treated with systemic PUVA therapy.
Eczema ; Erythema ; Lymphoma ; Photosensitivity Disorders* ; PUVA Therapy* ; Skin ; Solar System

BACKGROUND:Determination of the minimal erythema dose (MED) is important for developing a phototherapy protocol and to diagnosis photosensitivity disorders. But obtaining a precise and reproducible MED is quite difficult because a phototest for erythema is based on subjective assessment. OBJECTIVE: The objective of our study was to compare the gross interpretation of a phototest and the objective measurement using a spectrophotometer for determining the parameters of cutaneous narrow-band UVB (NBUVB) therapy. METHODS: A total of 14 psoriasis and 10 vitiligo patients who receiving NBUVB phototherapy with skin types III and IV were selected for this study. To perform phototesting, ten sites on the skin of the back were vertically exposed to a series of 10 NBUVB doses among 14 doses between 340 and 1,400 mJ/cm2. We interpreted the gross findings of erythema and measured the L*a*b* values with using a spectrophotometer at each phototest spot and at the control skin. Also, we evaluate the relationship between the gross presentation and the spectrophotometric analysis by delta E for the assessment of the minimal perceptible erythema (MPE) and MED. RESULTS: For all the subjects, the MEDs were measured in the 490~1,000 mJ/cm2 range. The average of the colorimetric values for the control skin were L*: 64.8, a*: 7.9 and b*: 19.8. Among them, the L* value and MED value were shown to be inversely correlated, and as the L* value was decreased, the MED was increased. For the MPE, the delta E, which was the color difference of the normal skin and the phototest area, was within the range of 1.5~3.0 in 17 of the 21 patients, and 4 patients were within the range of 1.0~1.5. For the MED, among the 21 patients, the delta E of 17 patients was within the range of 3.0~6.0, and 4 patients were within the range of 6.0~12.0. CONCLUSION: A spectrophotometer enables UV erythema to be assessed objectively and quantitatively, and this can compensate for the disadvantages of subjective gross interpretation when determining the MED. Delta E is a good novel and objective indicator for determining the MPE and MED. So, a spectrophotometer is a very useful instrument for developing a phototherapy protocol for psoriasis and other dermatoses and for making the diagnosis of photosensitivity disorders.
Erythema ; Humans ; Photosensitivity Disorders ; Phototherapy ; Psoriasis ; Skin ; Skin Diseases ; Vitiligo

BACKGROUND:Determination of the minimal erythema dose (MED) is important for developing a phototherapy protocol and to diagnosis photosensitivity disorders. But obtaining a precise and reproducible MED is quite difficult because a phototest for erythema is based on subjective assessment. OBJECTIVE: The objective of our study was to compare the gross interpretation of a phototest and the objective measurement using a spectrophotometer for determining the parameters of cutaneous narrow-band UVB (NBUVB) therapy. METHODS: A total of 14 psoriasis and 10 vitiligo patients who receiving NBUVB phototherapy with skin types III and IV were selected for this study. To perform phototesting, ten sites on the skin of the back were vertically exposed to a series of 10 NBUVB doses among 14 doses between 340 and 1,400 mJ/cm2. We interpreted the gross findings of erythema and measured the L*a*b* values with using a spectrophotometer at each phototest spot and at the control skin. Also, we evaluate the relationship between the gross presentation and the spectrophotometric analysis by delta E for the assessment of the minimal perceptible erythema (MPE) and MED. RESULTS: For all the subjects, the MEDs were measured in the 490~1,000 mJ/cm2 range. The average of the colorimetric values for the control skin were L*: 64.8, a*: 7.9 and b*: 19.8. Among them, the L* value and MED value were shown to be inversely correlated, and as the L* value was decreased, the MED was increased. For the MPE, the delta E, which was the color difference of the normal skin and the phototest area, was within the range of 1.5~3.0 in 17 of the 21 patients, and 4 patients were within the range of 1.0~1.5. For the MED, among the 21 patients, the delta E of 17 patients was within the range of 3.0~6.0, and 4 patients were within the range of 6.0~12.0. CONCLUSION: A spectrophotometer enables UV erythema to be assessed objectively and quantitatively, and this can compensate for the disadvantages of subjective gross interpretation when determining the MED. Delta E is a good novel and objective indicator for determining the MPE and MED. So, a spectrophotometer is a very useful instrument for developing a phototherapy protocol for psoriasis and other dermatoses and for making the diagnosis of photosensitivity disorders.
Erythema ; Humans ; Photosensitivity Disorders ; Phototherapy ; Psoriasis ; Skin ; Skin Diseases ; Vitiligo

Hydroa Vacciniforme is a rare, chronic, photosensitivity disorder witli onset in childhood that is characterized by recurrent, discrete vesiculation, necrosis and vacciniform scarring limited to sun exposed skin. We report a case of hydroa vacciniforme associated with ocular inwlvment in which vesicles could be induced only with single MED exposure to UVA.
Cicatrix ; Hydroa Vacciniforme* ; Necrosis ; Photosensitivity Disorders ; Skin ; Solar System

Persistent light reaction is a condition of chronic photodermatitis in which photosensitive reaction persists even after the rernoval of all photosensilizers. A 56-year-old man had experienced a recurrent dermatitis involving primarily the face, neek, forearms and hands for 9 years, this condition was aggravated by sunexposure. Photopatch testing disclosed a strongly positive reaction to chloropromazine, promethazine, acid trichlorocarbanilide, Phototesting also revealed lowered MED with UVA and UVB thar norrmal mean value.
Dermatitis ; Forearm ; Hand ; Humans ; Middle Aged ; Photosensitivity Disorders ; Promethazine

BACKGROUND: Human repeated insult patch tests (HRIPTs) are a final method for safety assessment of chemical ingredients. In the representative HRIPTs, the Shelanski and modified Draize require 200 participants, but the maximization and modified maximization tests require only 25. OBJECTIVE: To evaluate the safety of three sunscreen ingredients using the Shelanski and maximization methods. METHODS: Octylmethoxycinnamate, butylmethoxydibenzoylmethane, and octyltriazone (BASF) were prepared for the induction, as 25% ointment in white petrolatum base. After a 2-3 week resting phase, patch and photopatch tests were conducted, but pretreatment with SLS was only performed in the maximization test. The results were analyzed using the Chi-Square test. RESULTS: During the induction phase, there were only two (4%) weak positive reactions observed with the Shelanski method, whereas all 25 displayed strong or extremely positive reactions with the maximization method. Butylmethoxydibenzoylmethane displayed the most frequent elicitation reactions; the patch and photopatch tests displayed weak positive reactions in four (2%) and six (3%), and in one (4%) and two (8%), with the Shelanski and maximization tests, respectively. Taking into account two of the six reactors displayed positive reactions to petrolatum with the Shelanski test, the actual number of positive patch test reactions would be four (2%). The difference in results of the two methods was not statistically significant. CONCLUSION: Although it is not easy to conduct HRIPT on 200 subjects, and the results from the two tests were not significantly different, the reactions from the maximization tests were too severe to be recommended in humans.
G0 Phase ; Humans* ; Patch Tests* ; Petrolatum ; Photosensitivity Disorders ; Sunscreening Agents*

It is believed that the photopatch test is a valuable screening procedure for the determination of responsible antigenic substances in photoallergic contact dermatitis. But the technigues used for this procedure are cumbersome and require expensive equipment. In the present study, we adapted an easy and inexpensive photopatch test met- hod to our need. We report the results of this test method which was performed. in 21 patients with photodermatitis and 9 patients with polymorphic light eruption. 1. The UVB sensitivity determined by minimal erytherna dose (mean+-standard deviation) was I1618mW sec/cm in photodermatitis group, 108+ROmW sec/cm in polymorphic light eruption group and 126-+32mW-sec/cm in control group. But there was no significant difference among them (p>0. 05). 2. The reaction to UVA were negative in all groups. R. The photopatch test using IO potential photosensitizers revealed 12 positive responses in 9 patients; including 7 patients in photodermatitis group and 2 patients in polymorphic light eruption group. And the number of positive photopatch responses obtaied with each photosensitizer in RO patients with photodermatoses was 5 in chlorhexidine, 2 in paraaminobenzoic acid, musk ambrette and bithionol and 1 in chlorpromazine, respectively.
Bithionol ; Chlorhexidine ; Chlorpromazine ; Dermatitis, Photoallergic ; Humans ; Mass Screening ; Photosensitivity Disorders ; Photosensitizing Agents