Management of Chronic Photosensitive Eczema

To the Editor.— We read with interest the article entitled Management of Chronic Photosensitive Eczema 1 and would like to make a number of observations. Our experience with this condition, which comes within the spectrum of photosensitivity dermatitis/actinic reticuloid syndrome otherwise known as chronic actinic dermatitis, is that it is essentially a diagnosis of exclusion. Within the group of middle-aged to elderly men particulary affected, the use of thiazide diuretics is a common occurrence and, in the majority of cases, the drug is playing no role in the photosensitivity with the condition following the same pattern as non-thiazide-taking patients. In this group as a whole the finding of multiple contact allergy to a range of materials, including fragrances and compositae, 2,3 provides a useful management opportunity and careful avoidance of these agents, along with the use of broad-spectrum photoprotective agents, may enable a patient to not only enter clinical