Name
PHOTODERMATITIS
DESCRIPTION
DETAIL
CAUSES β’ Sunlight β’ Phenothiazines β’ Diuretics β’ Tetracyclines β’ Sulfonamides β’ Oral contraceptives β’ Topicals - psoralens, coal tars, photo-active dyes (eosin, acridine orange) β’ 5-fluorouracil β’ Quinine β’ Sunscreens containing paraaminobenzoic acid (PABA) -------------------------------------------------------------------------- DIFFERENTIAL DIAGNOSIS - Systemic lupus erythematosusLABORATORY Antinuclear antibody (ANA) to rule out systemic lupus erythematosus SPECIAL TESTS β’ Photo-testing - exposing patient to UV light β’ Photopatch testing - applying suspected agents and chemicals to patientβs skin β’ Skin biopsy - to rule out other disorders DIAGNOSTIC PROCEDURES Physical examination and medical history
TYPENOTES
RISK FACTORS: Job related exposure to sunlight, Light and fair colored skinGENERAL MEASURES β’ Avoid sunlight/limit exposure β’ Protective clothing/sunscreens β’ Ice packs/cold water compresses ACTIVITY Avoid sunlight DIET No special diet PATIENT EDUCATION β’ Avoidance of sunlight β’ Avoidance of photosensitizing drugs β’ Protective clothing (eg, Hats, long sleeves) β’ Sunscreens > 15 SPF DRUG(S) OF CHOICE β’ Topical corticosteroids (betamethasone valerate 0.1% cream) β’ NSAIDs (indomethacin 25 mg tid; aspirin; others) β’ Prednisone 0.5-1 mg/kg/d, for 3-10 days, for severe reactions β’ Antihistamines for pruritus (hydroxyzine 25-50 mg qid) β’ Sunscreens (> 15 SPF) for prevention. Use broadspectrum sunscreen to block both UVA and UVB. PABA may aggravate photodermatitis in sensitized patients (due to the sulfa moiety). PATIENT MONITORING As necessary for persistence or recurrence PREVENTION/AVOIDANCE . Sunlight avoidance/protective clothing . Identification and avoidance of causative drugs (see under Causes) . Sunscreens - apply before exposure . Zinc oxide - opaque, cosmetically less acceptable . Chemical - use sun-protective factor > 15 for maximum protection; substantively resistant to sweat and swimming; cosmetically more acceptable POSSIBLE COMPLICATIONS N/A EXPECTED COURSE/PROGNOSIS Good with avoidance/protection measures
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
ANTI-NUCLEAR ANTIBODY TEST, COMPLETE BLOOD COUNT, BIOPSY