Phototesting Can Provide More Personalized Care for Photoaggravated Atopic Dermatitis

Results from a new study revealed key features of photoaggravated atopic dermatitis (PAD). Investigators believe this could improve disease recognition and diagnosis while supporting development of personalized prevention and therapy.

According to the study, photoaggravated atopic dermatitis affects and estiamted 1.4%-16% of patients with atopic dermatitis (AD). With limited published data PAD lacks adquate characterization.

Exposure to UV radiation (UVR) has been linked to reduced atopic dermatitis with artificial UVR sources serving as a therapeutic option for some cases. However, for certain patients, sunlight exposure and summer months have shown a positive relationship with the exacerbation of eczema.

Clinicophotobiological Characterization

Kirsty Rutter, MRCP, Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, led a team of investigators through a case series study using cross-sectional data.

The team collected data from 120 consecutive patients who were diagnosed with photoaggravated atopic dermatitis between January 2015-October 2019 at a tertiary center referral unit for photobiology. The research objective was to provide detailed clinica and photobiological characterization of PAD.

Descriptive statistics and regression analysis were implemented to evaluate associations between demographic and clinical data from the routinely collected standardized clinical and photobiological data.

Photoinvestigation

Among the 869 patients who participated in photoinvestigation, 120 (14%) received a PAD diagnosis (69 female [58%]; median age, 45 [IQR, 31-61] years; range, 5-83 years; skin phototypes [SPTs] I-VI). Adult patients with PAD made up the majority (87%) of this population with 104 diagnoses.

All patients had a history of atopic dermatitis with 62 (60%) having experienced sunlight-provoked or photodistributed eczema. Results yielded the median age represented at photosensitivity onset was 37 years.

A score of greater than 10 was observed on the Past-year Dermatology Life Quality Index for 80 of 103 adults (78%), and 82 of 119 (69%) had vitamin D level insufficiency or deficiency. For 93% of patients the broadband UV radiation provocation test results were positive.

"In this case series study, PAD affected patients with different ages and SPTs and was associated with substantially impaired quality of life," investigators wrote. "The findings suggest that confirming PAD through phototesting may provide better personalized care for patients through identification of provoking wavelengths, relevant photocontact allergies, and appropriate photoprotection advice."

The study, "Clinicophotobiological Characterization of Photoaggravated Atopic Dermatitis" was published in Jama Dermatology.