ABSTRACT Chronic actinic dermatitis (CAD) is an immunologically mediated photodermatosis associated with delayed hypersensitivity reaction. It is a persistent photoinduced disease accompanied by itchy eczematous skin lesions at the areas exposed to sunlight. Dermatosis occurs mainly in males. The onset of the disease occurs mainly in spring and summer, and then can relapse in autumn and winter. Phototesting of these patients shows significant decrease in the threshold level of UV-A and/or UV-B. At the same time, patients may be hypersensitive to plant allergens of weeds and have increased level of IgE. We discuss the cases of three male patients aged 65 years (patient A.), 57 years (patient K.), and 63 years (patient B.), who developed eczematous rash first on the exposed, and then on covered skin areas. These patients suffering from CAD demonstrate chronic recurrent course and different clinical variants of the disease. Diagnosis was complicated due to clinical presentation similar to atopic dermatitis. All these patients had concomitant pathology of the gastrointestinal tract and hepatobiliary system. Difficulties in timely recognition and chronic course of the disease necessitate improvement of the methods of diagnosis and treatment.