Clinical implications

Both ultraviolet light and systemic treatments such as short courses of oral steroids and ciclosporin are probably useful and safe to use in the person depicted in the case scenario. Safety is a factor limiting the long-term use of all of these agents. Planned short-term use (2-3 months) to try and gain a remission or give the person a "holiday" from severe symptoms seems a reasonable option, resorting to topical treatments such as intermittent use of potent topical steroids or tacrolimus once control is achieved.

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