Journal de dermatologie et des maladies dermatologiques

An Unusual Presentation of Actinic Reticuloid: A Pigmented and Depigmented Puzzle

Abstract

Michelle B Tarbox

Background: Actinic Reticuloid (AR) is idiopathic photosensitivity dermatitis. AR presents with eczematous scaly plaques in a sun-exposed distribution, typically on the head and neck. AR is most commonly seen in older males with a significant history of sun exposure. Observation: A 64 year-old Hispanic male with a long-standing history of widespread vitiligo, presented with a two-week history of a pruritic, erythematous eruption of his head, neck, and hands. Sun-exposed skin which had been previously depigmented by vitiligo was involved, while normally pigmented sun-exposed areas were spared. Skin biopsy from scaly plaques on his vitiliginous skin was consistent with a diagnosis of AR. Treatment with topical and oral corticosteroids, in combination with sun protection, lead to marked improvement of symptoms. Conclusion: This case demonstrates an unusual presentation of actinic reticuloid with an unusual predilection for skin which had been previously depigmented due to vitiligo.