Support Group for Sun Sensitive People
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We are a support group for people who suffer from sun sensitivities such as solar urticaria, lupus, porphyria, sun rash, sun hives, photosensitivity, sun allergy, rheumatoid arthritis, xeroderma pigmentosum, albinism and more. We share our experiences and ways of coping and living with sun sensitivity such as sunscreens, clothing, hats, sunglasses and the effectiveness of medical treatments.
 

Diagnostic Chart for Sun Sensitive Conditions

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The diagnostic chart (below) can be used to help figure out what is wrong with people who have photosensitivity - perhaps, as a diagnostic tool for you and your doctor. Sometimes, all a doctor needs is a list to spark his or her thinking process. Your doctor should be your first choice to determine what kind of sun sensitive condition that you have.  

The diagnostic chart in Table 1 is created from several sources referenced on the Diagnosis web page.  Links to images or pictures of the skin condition are in the diagnostic chart. Also links to medical articles describing the particular photosensitive condition are also in the diagnostic chart.  The Diagnosis web page  has links to several good articles on diagnosing photosensitivity as well as statistics for different sun sensitive conditions. 

Diagnostic chart overview:

Chemical photosensitivity can be from either ingesting something (drugs, food, liquids), or from being in contact with something  on the skin (topical) like plants, liquids, skin products, perfumes, etc..  Photosensitivity reactions from skin contact  result in patterns of where the substance contacted the skin and the substance was exposed to sunlight. The result can be bizarre patterns such as dot patterns from a weed whip or odd blotches from spilling lime juice.  Photosensitivity related to plants is called phytophotodermatitus. Reactions from chemical photosensitivity from ingesting something are usually confined to sun exposed skin. Chemical photosensitivity can result in phototoxic or photoallergic reactions.

Idiopathic acquired photodermatoses are sun related skin conditions from an unknown cause and include solar urticaria, polymorphous light eruption and others.1

Genetic and metabolic disorders include  porphyrias, xeroderma pigmentosum, Cockayne's syndrome, and Bloom's syndrome. Nutrional deficiencies include pellagra and Hartnup disease.1

Diseases that may be aggravated by sunlight  include lupus erythematosus, acne vulgaris, Dariers disease, Grovers disease  and herpes simplex.6

Table 1: Diagnostic Chart for Sun Sensitive Conditions (IN WORK)

  Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
Normal sunburn sunburn reaction 30 minutes to 4 hours after exposure3 peaks at 24 hours and lasts up to 72 hours.3  Skin peels 2 to 7 days later.3 exposed skin severe cases have swelling and blistering.  
             
Chemical photosensitivity (contact or ingested)            
Contact photosensitivity from something in contact with the skin either phototoxic or photoallergic reaction (see below)     Usually exposed skin with exposure to both contact item and the sun.  Consider airborne  like sawdust, and topicals like plants,  sunscreens, perfumes,  cosmetic & bath products.4  
Chemical  photosensitivity phototoxic,  Images, Exaggerated sunburn reaction after only a short exposure (ingested or contact) within hours of exposure   Exposed skin List of drugs, recent drug ingestion, or applied to skin. Also ingested items like quinine. Any age
Chemical photosensitivity photoallergy,  Images, eczema, rash  (ingested or contact) 24 to 48 hours after exposure   First, exposed skin, may later spread to non-exposed areas. List of drugs, recent drug ingestion, or applied to skin. Also ingested items like quinine. Any age
Phytophotodermatitis (plants), Images, Redness and blisters, changes in pigment in odd, bizarre shapes  such as linear streaks3   Hyperpigmentation can last for months.3 Skin exposed to plant and sun. Common plants: celery family, certain grasses, carrots, limes, citrus, daisy family.3 Exposure to plants in spring and summer.3  
             
Idiopathic acquired photodermatoses1
(Sun related skin conditions from an unknown cause)		 Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
Solar urticaria,  Images, rash, hives (urticaria) , swelling (angioedema) within 30 minutes of exposure hours Exposed skin  Sunlight, through glass, fluorescent lighting can cause reactions. 4  
Chronic actinic dermatitis (actinic reticuloid), photosensitivity dermatitus4 Persistent light reaction,  Images, lichenified plaques, chronic eczematous pattern of photosensitivity4 . months, worst, in summer, can persist all year.4 Initially affects exposed skin, but spreads to  non-exposed skin4 Often follows years of  contact allergies. Sunlight, through glass, fluorescent lighting can cause reactions4 typically older men4
Actinic prurigo, Hutchinson’s summer prurigo itchy, acute facial or forearm dermatitis with edematous papules and vesicles which progress to crusting and epidermal thickening3   months face, forearms, both exposed & non-exposed skin occurs in spring, annually North and South American Indians, female/male: 2:1 mostly before adulthood2
Polymorphic light eruption (PMLE),  Images, Thought to be sunburn or prickly heat4, discrete erythematous papules or plaques3  new lesions appear within hours or days of sun exposure3  remain 1 to 7 days, heals without scarring2 exposed skin, but not all exposed skin occurs in spring, some improve through summer, some get worse4 onset of disease is sudden, later childhood before age 303, mostly female2 Up to 30% in women using tanning beds4
Hereditary polymorphic light eruption see above   see above   family history North and South American Indians,
Juvenile spring eruption,  (PMLE related) Images, 2  to 3 mm discrete papules or vesicles on ears and cheeks3 Tiny blister on rims of ears4   lasts 1 or 2 weeks, then reappears next spring3   22% will go on to develop PMLE3 fair skinned boys, 5 to 12 years old3
Hydroa vacciniforme,  (PMLE related) Images, images2, a few discrete, deep-seated vesicles/papules on photoexposed areas of face, hands and forearms4,  

Can last up to 4 weeks. Heal with scarring.3

 More episodes with  sun exposure3 Rarely the eye is involved. Rarest form of PMLE3 childhood7
             
Genetic disorders7 Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
Xeroderma pigmentosum,  Images, prolonged sunburn, numerous freckles, skin dryness, photophobia3,4   sunburn which takes weeks to go away3 tumors, skin cancer4 family history, Onset of skin lesions by 18 months.3 infancy, childhood
Cockayne's syndrome         family history infancy7
Bloom's syndrome         family history infancy7
Rothmund Thompson syndrome
           infancy7
Ataxia telangiectasia           childhood7
             
Metabolic disorders7 Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
porphyrias         family history  
Erythropoietic protoporphyria,  Images, intense burning pain, no visible skin rash pain within minutes of sun exposure3   Intense sun may result in facial edema, erythema, or urticaria3. family history, inherited disorder of porphyrin metabolism3 infancy, childhood
porphyria cutanea tarda  (PCT),  Images, blisters4         typically adults rather than children4
Hartnup disease           childhood7
Phenylketonuria           infancy7
             
Nutritional disorders7 Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
Pellagra            
             
Collagen vascular disorders7 Reaction type Occurs within ? after exposure Time for reaction to go away Area affected  Other clues (usually) Age usually discovered, usually found in male/female 
Lupus Erythematosus, discoid,  Images, images2,  lesions with  erythematous papule or plaque some scaling, malar rash5   eruption occurs 1 to 7 days after exposure3 mostly exposed skin   2:1 female to male, most often ages 20 to 405
Neonatal lupus  Images         infancy, childhood
Dermatomyositis            
             
             
1[Kwok] Evaluation of A Photosensitive Rash, DR Colin Kwok, NSC Bulletin For Medical Practitioners -> Vol 11 No 1, 2000, National Skin Centre [National Skin Center]
2[Pediatric]
3Chapter 10, Sun Sensitivity. Color Textbook of Pediatric Dermatology, 3rd edition, By William L. Weston, MD; Joseph G. Morelli, MD; and Alfred Lane, MD, ISBN 0323018211 · Published April 2002 
4Chapter 28  Photodermatology and Photodermatoses, Diseases of the Skin, Gary M. White & Neil H. Cox, 2002, W. B. Saunders. White
5eMedicine - Lupus Erythematosus, Discoid Article by Jeffrey P Callen, MD
6Photosensitivity, by David R. Bickers, MD, Best Practice of Medicine. March 2000. http://merck.micromedex.com/index.asp?page=bpm_viewall&article_id=CPM02DE418&show_banner=no
7 Inamadar AC, Palit A. Photosensitivity in children: An approach to diagnosis and management. Indian J Dermatol Venereol Leprol 2005;71:73-79.  from: http://www.ijdvl.com/article.asp?issn=0378-6323;year=2005;volume=71;issue=2;spage=73;epage=79;aulast=Inamadar

   


Consult with your physician regarding any treatments or medical advice suggested by this website. 

We are not physicians, we are people trying to learn about our conditions and better our lives. We try to be accurate, but the articles and advice may have errors, become out-of-date, or even give bad advice.


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