(1997; 132 pages) [French] [Spanish]
Actinic prurigo, which occurs particularly among people of American Indian and Asian descent, first appears during childhood. It usually regresses completely during adolescence and early adulthood but can persist longer. Recurrent patchy oedematous erythema results in the formation of persistent excoriated plaques, papules and nodules. Cheilitis is common, particularly during the early phases of the disease. Vesicles and small pitted scars sometimes develop on the face, while chronic conjunctivitis and pterygium formation are common among affected children in South America, New Mexico and Saskatchewan, Canada.
Sunscreens, when used regularly, provide some protection. The cutaneous signs are suppressed by thalidomide and, to a lesser extent, topical corticosteroids, but they recur within a few weeks of discontinuation of treatment. Thalidomide should be avoided in women of child-bearing age, since it is a proven teratogen. If this is not possible, it is imperative that pregnancy be excluded before this treatment is instituted. Effective contraception must be used during the 4 weeks preceding and following treatment, as well as during the treatment period. Should pregnancy occur despite these precautions, there is a high risk of severe malformation of the fetus.