Current Dermatology Reports

, Volume 8, Issue 2, pp 63–72 | Cite as

Actinic Prurigo and Hydroa Vacciniforme

  • Brandon L. AdlerEmail author
  • Vincent A. DeLeo
Photodermatology (B Adler and V DeLeo, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Photodermatology


Purpose of Review

To summarize current knowledge pertaining to two photodermatoses, actinic prurigo (AP) and hydroa vacciniforme (HV), both of which routinely have onset in childhood.

Recent Findings

AP is an immune-mediated photodermatosis associated with human leukocyte antigen DR4 that commonly features cheilitis and conjunctivitis. It mostly affects American Indian/Latin American Mestizos and rarely white and Asian patients, who manifest different disease phenotypes. The diagnosis is clinical, but follicular cheilitis is a characteristic mucosal biopsy finding, and phototesting may be helpful. Hallmarks of treatment are photoprotection and thalidomide.

HV is a photodermatosis related to Epstein-Barr virus infection that causes varioliform scarring. Classic HV is benign and self-limited and must be distinguished from hydroa vacciniforme-like lymphoproliferative disorder (HVLLPD), a systemic disease most common in Asia and Latin America with risk of progression to lymphoma. Limited treatments are available, but accumulating data suggest chemotherapy is associated with worse outcomes in HVLLPD.


As understanding of these photodermatoses progresses, important knowledge gaps persist. AP’s pathogenesis remains incompletely elucidated, and therapeutic investigation has stagnated. Despite enhanced description of HV and HVLLPD, both lack standardized effective therapy.


Actinic prurigo Thalidomide Hydroa vacciniforme Hydroa vacciniforme-like lymphoproliferative disorder EBV Photosensitivity 


Compliance with Ethical Standards

Conflict of Interest

Brandon L. Adler and Vincent A. DeLeo declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. 1.Department of Dermatology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

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