medigraphic.com
Órgano oficial de la Sociedad Mexicana de Cirugía Dermatológica y Oncológica, AC

2025, Number 2

<< Back Next >>

Dermatología Cosmética, Médica y Quirúrgica 2025; 23 (2)

Actinic prurigo treatment: an evolution from photoprotection to biological therapy

Santamaría DD, Niebla L, Vega MME

Language: Spanish
References: 27
Page: 139-145
PDF size: 205.79 Kb.


ABSTRACT

Background: actinic prurigo (AP) is a chronic, immune-mediated photodermatosis associated with type iv hypersensitivity induced by UV radiation. It predominantly affects indigenous and mestizo populations in Latin America, with high prevalence in high-altitude areas. Its pathophysiology involves CD4+ t lymphocytes and HLA-DR4 expression. The objective of our review is to describe both conventional and emerging treatments for AP, evaluating their published efficacy and safety.
Methodology: a literature review was conducted in biomedical databases, selecting observational studies, clinical trials, and systematic reviews on the treatment of AP published in the last 20 years.
Results: conventional treatments, such as thalidomide and cyclosporine a, have been effective but present significant adverse effects. Newer approaches, such as JAK inhibitors (baricitinib) and monoclonal antibodies (dupilumab), have shown better efficacy and safety, although their access is limited.
Conclusions: biological therapies are emerging as promising options for refractory AP, but their high cost and restricted availability hinder their widespread application. Further studies are required to optimize therapeutic strategies in vulnerable populations.


REFERENCES

  1. Hojyo-Tomoka MT, Vega-Memije ME, Cortés-Franco R y Domínguez-Soto L, Diagnosis and treatment of actinic prurigo, DermatolTher 2003; 16(1):40-4.

  2. Vega-Memije ME, Cuevas-González JC, Hojyo-Tomoka MT yRodríguez-Lobato E, Actinic prurigo as a hypersensitivity reactiontype iv, Int J Dermatol 2017; 56(6):e135-6.

  3. Cuevas-González JC, Rodríguez-Lobato E, Hojyo-Tomoka MT yVega-Memije ME, Actinic prurigo: a condition that affects theLatin American population, Int J Dermatol 2019; 58(11):e220-1.

  4. Moncada B, Actinic prurigo, Int J Dermatol 1983; 22(7):415.

  5. Vera Izaguirre DS, Zuloaga Salcedo S, González Sánchez PC,Sánchez Lara K, Chávez Tapia N, Hojyo Tomoka MT et al., Actinicprurigo: a case-control study of risk factors, Int J Dermatol 2014;53(9):1080-5.

  6. Cuevas-González JC, Rodríguez-Lobato E, Mancheno-ValenciaA, Hojyo-Tomoka MT, Domínguez-Soto L y Vega-Memije ME,Prurigo actínico: perfil demográfico de los últimos 20 años enla División de Dermatología del Hospital General Dr. ManuelGea González en la Ciudad de México, Dermatol Rev Mex 2014;58(6):509-12.

  7. Valbuena MC, Muvdi S y Lim HW, Actinic prurigo, Dermatol Clin2014; 32(3):335-44, viii. doi: 10.1016/j.det.2014.03.010. pmid:24891055.

  8. Pardo-Zamudio AC, Valbuena MC, Jiménez-Torres HD y Colmenares-Mejía CC, Actinic prurigo in a dermatological referencecenter in Colombia: 108 cases, Biomedica 2020; 40(3):487-97.

  9. Lestarini D, Khoo LS y Goh CL, The clinical features and managementof actinic prurigo: a retrospective study, PhotodermatolPhotoimmunol Photomed 1999; 15(5):183-7.

  10. Lee CN, Chen TY y Wong TW, The immunogenetics of photodermatoses,Adv Exp Med Biol 2022; 1367:369-81.

  11. Ortiz-Castillo JV, Boto de los Bueis A, De-Llucas-Laguna R,Pastor-Nieto B, Peláez-Restrepo N y Fonseca-Sandomingo A,Ciclosporina tópica como tratamiento del prurigo actínico ocular,Arch Soc Esp Oftalmol 2006; 81(11):661-4.

  12. Umaña A, Gómez A, Durán MM y Porras L, Lymphocyte subtypesand adhesion molecules in actinic prurigo: observationswith cyclosporin a, Int J Dermatol 2002; 41(3):139-45.

  13. Estrada-G I, Garibay-Escobar A, Núñez-Vázquez A, Hojyo-TomokaT, Vega-Memije E, Cortés-Franco R et al., Evidence that thalidomidemodifies the immune response of patients sufferingfrom actinic prurigo, Int J Dermatol 2004; 43(12):893-7.

  14. Watts-Santos A, Martínez-Rico JC, Gómez-Flores M, Ocampo-Candiani J y Alba-Rojas E, Thalidomide: an option for the pediatricpatient with actinic prurigo, Pediatr Dermatol 2020;37(2):362-5.

  15. Arrese JE, Domínguez-Soto L, Hojyo-Tomoka MT, Vega-MemijeE, Cortés-Franco R, Guevara E y Piérard GE, Effectors of inflammationin actinic prurigo, J Am Acad Dermatol 2001; 44(6):957-61.

  16. Cuevas-González JC, Vega-Memije ME, García-Vázquez FJ, Rodríguez-Lobato E y Farfán-Morales JE, Apoptosis and apoptoticpathway in actinic prurigo by immunohistochemistry, Med OralPatol Oral Cir Bucal, 2016; 21(1):e53-8.

  17. Torres-Álvarez B, Baranda L, Fuentes C, Delgado C, Santos-Martínez L, Portales-Pérez D, Moncada B y González-Amaro R,An immunohistochemical study of uv-induced skin lesions inactinic prurigo. Resistance of Langerhans cells to uv light, Eur JDermatol 1998; 8(1):24-8.

  18. Guevara E, Hojyo-Tomoka M, Vega-Memije M et al., Estudio inmunohistoquímicopara demostrar la presencia de linfocitos ty b en el infiltrado inflamatorio de las biopsias de piel, labio yconjuntiva de pacientes con prúrigo actínico, Dermatol Rev Mex

  19. 1997; 41:223-6.19. Barker CS, Sattele L, Strat N, Daniel S, Snyder A, Siegel M yWine Lee L, Dupilumab as treatment of actinic prurigo suggestspathophysiologic mechanism of disease: a case series, J AmAcad Dermatol Case Rep 2024; 46:89-91.

  20. Eickstaedt JB, Starke S, Krakora D, Hinshaw M y Arkin LM,Clearance of pediatric actinic prurigo with dupilumab, PediatrDermatol 2020; 37(2):1-3.

  21. Malekan M, Mohandesi NA, Rahmatpour Rokni G, Babaei M,Montazer F y Gholizadeh N, Successful treatment of actinic prurigowith baricitinib in an 8-year-old child: a case report, PediatrDermatol 2024; 41(6):1159-61.

  22. Gil-Lianes J, Luque-Luna M y Morgado-Carrasco D, Completeresponse of actinic prurigo to oral baricitinib, J Dtsch DermatolGes 2024; 22(6):837-8.

  23. Peruilh-Bagolini L, Jahr-Andrade C, Gárate-González M, Heredia-Miranda L, Aranibar-Durán L y Ramírez-Rondón C, Hydroxychloroquinein the treatment of actinic prurigo in pediatric patients:report of three cases, J Dtsch Dermatol Ges 2022; 20(9):1226-7.

  24. Alamillo-Velázquez J, Ortiz-Morales G, González-González SE,López-Altamirano DF y Rodríguez-García A, Actinic conjunctivi-tis and its relationship with prurigo in an indigenous populationfrom the Highlands of Chiapas, Mexico, Int Ophthalmol 2024;44(1):4.

  25. Stump J, Powers J, Stone M y Dhinsa H, Attenuation of actinicprurigo eruptions with Polypodium leucotomos supplementation,Pediatr Dermatol 2022; 39(1):145-6.

  26. Sangmala S, Wongpraparut C, Silpa-Archa N, Chaiyabutr C, Exploringadult-onset actinic prurigo in Thailand, Dermatol Reports2023; 16(3):9810.

  27. Ker KJ, Chong WS y Theng CT, Clinical characteristics ofadult-onset actinic prurigo in Asians: a case series, Indian J DermatolVenereol Leprol 2013; 79(6):783-8.




2020     |     www.medigraphic.com