Actinic Prurigo (PMLE of Native Americans)

  • Similar to PMLE but seen mainly in native American children; begins before age 10 in most cases (earlier than PMLE) and typically worse in spring and summer
  • Presents with erythematous edematous plaques with ensuing hemorrhagic crust and excoriations on exposed surfaces; pitted or minute linear scars left after lesions heal; associated cheilitis and conjunctivitis; improves/resolves in adolescence
  • Histology: epidermal spongiosis with dermal edema, perivascular mononuclear cell infiltrate
  • Treatment: photoprotection and topical corticosteroid, thalidomide (only effective systemic agent)