A 60-year-old man had noticed itchy erythema on the face and scalp 2 years previously. He was referred to the Department of Dermatology, Kyusyu University Hospital because the erythema had gradually developed on the extremities and the symptoms were resistant to regular topical steroid or oral antihistamines. On examination, patchy pigmentation and depigmentation were observed on the face and neck. Minimum erythematous dose was markedly reduced (UVA, 8J/cm 2; UVB, 0.03J/cm2) and a biopsy specimen showed chronic dermatitis, thus establishing the diagnosis of chronic actinic dermatitis (CAD). Findings from another biopsy obtained from the erythema induced by repeated UVA irradiation (8 J/cm2/day, 3 consecutive days) were similar to those of the previous specimen. Topical application of tacrolimus ointment profoundly improved the facial erythema with the help of a strong sunscreen. Tacrolimus ointment is considered to be a practical and efficient treatment for CAD in combination with the use of a sunscreen.
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