Actinic Prurigo is a sunlight induced itchy, pimply, idiopathic photodermatoses. It is uncommon in Caucasian populations with a preponderance in native populations in North, Central and South America. It is more frequent in females by a factor of 2 – 4 and has a childhood onset, with a mean age at presentation of less than 10 years.
Actinic Prurigo is triggered by UV radiation in genetically susceptible individuals. Some researchers have proposed that it is an autoimmune disorder, the putative antigen being an epidermal protein which is transformed by UV exposure. Family studies have indicated that the disorder has a strong association with the HLA class II gene DRB1*04:07, which is found in 60 – 70% of patients compared to 4 – 8% of DR4 controls. HLA-DRB1*04:01 is the next most prevalent gene associated with Actinic Prurigo, found in approximately 20% of patients.
Actinic Prurigo presents with symptoms very similar to polymorphous light eruption (PLE), which is another sunlight induced skin irritation. Genetic testing helps to distinguish the two as PLE has no HLA association. Care is needed in interpreting the results though as a small number of patients do present with both Actinic Prurigo and PLE.
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