Actinic Conjunctivitis and its Relationship with Prurigo in an Indigenous Population from the Highlands of Chiapas, Mexico

Abstract

Abstract Purpose Actinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis affecting high-risk populations. We analysed the clinical manifestations and onset of actinic conjunctivitis (AC) and its relationship with prurigo (AP) in a susceptible population. Methods An observational and cross-sectional study was performed on the Indigenous populations from the highlands of Chiapas, Mexico. A thorough dermatologic and ophthalmologic examination was performed on patients attending a primary health care centre. Clinical features, labour and environmental factors, onset timing, and clinical staging of AC and AP were analysed. Results Of 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC and 14 patients (25.9%) AP. Mean age of diagnosis was 36.18 ± 18.52 years (range: 6-70 years). Mean residence altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 hours a day (range: 0.5 - 12 h). 90.7% reported exposure to biomass fuels when cooking, and 50% to farm animals. AC was the sole manifestation in 70% of cases. All patients had nasal and temporal photo-exposed conjunctiva affected. 12.9% of eyes were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. 83.3% of the patients had a hyperpigmented lesion and 35.1% had an evaporative dry eye disease. Conclusions The prevalence of AC was 1.8%. AC may be the initial or sole manifestation of AP. AC clinical manifestations included a symmetric papillo-follicular conjunctival reaction, evaporative dry eye disease, linear leucoma, hyperpigmented lesions, and pseudo-pterygia formation.