Solar Dermatitis

Exposure to strong sunlight produces dermatitis which may be of an acute or chronic nature. The actual degree of the bum depends upon the intensity of the sunlight and the environments under which the integument is exposed. Snow and water reflect sunlight strongly especially the ultraviolet beam; hence, sunburns occur easily on the mountains and near the sea. Dark people sunburn less frequently than the white; people used to exposing themselves to the sun, can stand sunlight better than those who do not. Blondes and red heads are sensitive to sunlight. The signs of sunburn vary from redness to swelling and blistering. The eyelids may swell, if the face is affected. The eruption is usually bilateral and symmetrical. Subjectively, the patient complains of burning and itching. The signs develop several hours after exposure. A mild attack clears up within a couple of days; the inflamed epidermis peels off, leaving behind hyper-pigmentation, freckles, and sometimes though rarely, depigmentation. A severe attack may be accompanied by prostration and shock, and will take weeks to subside; it may leave behind some degree of atrophy or scarring.

Chronic sunburn is produced in fair people by exposure to strong sunlight over a period of years. The integument looks like that of a sailor, there being patchy and diffuse pigmentation, wrinkling, atrophy, telangiectasia and keratoses. There is a tendency to develop epitheliomata. Exposed parts like the face, neck, the dorsum of the hands and feet, are the sites chiefly affected. Cutis rhomboidalis nuchae is a form of chronic solar dermatitis of the back and neck. It is seen as thick and red skin divided into rhomboidal areas by prominent creases.

Diagnosis of Solar Dermatitis

It is not difficult in ordinary cases, because of the typical features, and the history of the environments under which they develop. Erysipelas and cellulitis can be eliminated by their localized nature and raised local and systemic temperature.

Treatment of Solar Dermatitis

It consists in:

Prophylactic: People with light skin, blondes, red heads and also those with photo-sensitivity, should avoid direct and prolonged exposure to the strong sun. In sun-bathing, exposure to the sun should be increased gradually, in stages. Such people should use the sun-shades, umbrellas, and apply evenly on exposed surfaces anti-actinic creams like Paraminol (P) or para-amino-benzoic acid or titanium dioxide in lactocalamine lotion.

Curative:

1. Locally, lotion calamine in mild cases, and lotion hydrocortisone in severe cases. These should be substituted by zinc cream and eucerine as the acute stage subsides.

2 Antihistaminic and corticosteroids by mouth in moderate and severe cases respectively.

3. Bed rest, plenty of fluids, salt and lime in severe cases.

4. In chronic cases, lanoline cream with vitamins may help to soften the skin, but it never returns to normal. Dermabrasive surgery may help to some extent. Keratoses and epitheliomas are treated by surgical or electrical excision etc.

Corn and Callus

Bunion

Cracking

Maceration

Acrocyanosis

Livedo reticularis

Frost bite

Solar dermatitis

Xeroderma pigmentosum

Solar eczema

Solar urticaria

Actinic reticuloid