O'Brien's actinic granuloma in association with prolonged doxycycline phototoxicity.
O'Brien's actinic granuloma is clinically characterized by annular papules and plaques on sun-exposed areas of skin. These lesions often occur insidiously on a background of severe solar elastosis; however, an acute variant following sunburn has been reported in the literature. We present two cases of acute actinic granuloma precipitated by episodes of sunburn occurring on a background of prolonged doxycycline phototoxicity. Biopsies from both patients showed a histiocytic infiltrate with multinucleate giant cells engulfing elastotic material, with a reduction of elastin towards the centre of the papule. Marked resolution of the lesions was noted after 8 weeks of treatment with betamethasone dipropionate 0.05% ointment in optimized vehicle together with adequate photoprotection in the form of broad-spectrum sunscreens.
Lim
Davin S
DS
382 Health Flight, Royal Austalian Air Force Base, Amberley, Queensland, Australia. davinlim@hotmail.com
Triscott
Joe
J
D000279:Administration, Cutaneous; D000328:Adult; D000962:Antimalarials / Q000009:adverse effects*; D001623:Betamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000009:adverse effects*; D006099:Granuloma / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D006801:Humans; D008288:Malaria / Q000188:drug therapy; D008297:Male; D009333:Neck; D012871:Skin Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D013472:Sunlight / Q000009:adverse effects*
D000962:Antimalarials; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D004318:Doxycycline