photosensitivity
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Etiology
- idiopathic
- actinic prurigo
- chronic actinic dermatitis
- hydroa vacciniforme
- polymorphous light eruption
- solar urticaria
- hydroa aestivale
- actinic reticuloid
- metabolic
- porphyrias
- Bloom's syndrome
- Cockayne's syndrome
- Rothmand-Thompson syndrome
- Xeroderma pigmentosum
- phenylketonuria
- albinism
- Hartnup disease
- kwashiorkor
- pellagra
- carcinoid syndrome
- pseudoporphyria
- neoplastic
- degenerative
- photoaggravated
- drug induced photosensitivity
Pathology
- phototoxic or photoallergic abnormal skin response to ultraviolet radiation[4]
- phototoxic reactions
- more common than photoallergic reactions
- occur after threshold concentration of culprit agent (doxycycline, voriconazole ...)
- present as an exaggerated sunburn within minutes to hours of sun exposure
- photoallergic reation
- cell-mediated immune response found in previously sensitized individual
- can be elicited by re-exposure to small amounts of an offending agent
- occur more commonly after topical exposure of a sensitizing agent
- present as pruritic, eczematous eruptions within 24-48 hours after sun exposure[4]
Laboratory
- complete blood count (CBC)
- serum chemistries
- serology
- erythrocyte chemistries
- urine
- feces
- skin biopsy
Diagnostic procedures
- Phototesting
- patch & photopatch testing
- assessment of DNA repair
Management
- avoid sunlight
- sunblock (Mexoryl may help)
- antihistamines for pruritus
- topical glucocorticoids[4]
More general terms
More specific terms
Additional terms
References
- ↑ Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 983-89
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 331
- ↑ Prescriber's Letter 12(8): 2005 Drug-Induced Photosensitivity Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200509&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 4.0 4.1 4.2 4.3 Medical Knowledge Self Assessment Program (MKSAP) 15, 19 American College of Physicians, Philadelphia 2009, 2022
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ Jump up to: 5.0 5.1 Livideanu CB et al. Late-onset x-linked dominant protoporphyria: An etiology of photosensitivity in the elderly. J Invest Dermatol 2013 Jun; 133:1688 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23223129
Frank J et al. Photosensitivity in the elderly - think of late-onset protoporphyria. J Invest Dermatol 2013 Jun; 133:1467 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23673504 - ↑ Jump up to: 6.0 6.1 Zink A and Ring J Phototoxic Dermatitis N Engl J Med 2014; 371:559. August 7, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25099580 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1315566