Topical photoallergic contact dermatitis (PACD) is thought to represent a delayed-type hypersensitivity reaction when an exogenous agent combines with some component of the skin in the presence of ultraviolet (UV) and/or visible light.
Although PACD is relatively rare, it is also underdiagnosed as a cause of sunlight-exposed site dermatitis.
Photopatch testing is the investigation of choice for topical PACD, and a European consensus methodology for photopatch testing should allow greater comparison between centers.
Currently, organic UV sunscreen absorbers and topical nonsteroidal anti-inflammatory drugs (NSAIDs) are the commonest photohaptens encountered by patients.
Clinicians should be aware of potential new photohaptens in the environment and have a low threshold for photopatch testing such agents.
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