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Photosensitive Dermatitis

»What is the definition of photosensitivity?
»What is the difference between a phototoxic reaction and a photoallergic reaction?
»What is the clinical appearance of a photodistributed eruption?
»Name some of the most common topical phototoxic and photoallergic agents and their action spectrums.
»Name some of the most common systemic phototoxic and photoallergic agents and their action spectrums.
»Give some examples of unique phototoxic reactions.
»What are some scenarios in which the skin may be more sensitive to ultraviolet radiation?
»What are the important questions to ask a patient with suspected photosensitivity?
»What are the most common causes of photosensitive dermatoses?
»What is persistent light reactivity?
»What is polymorphous light eruption (PMLE)?
»How is PMLE diagnosed?
»How is PMLE treated?
»What is actinic prurigo?
»What is solar urticaria?
»Discuss the differential diagnosis of photodermatoses in infants or young children.
»How do hydroa aestivale and hydroa vacciniforme differ?
»Which porphyrias are associated with photodermatoses?
»Describe the cutaneous changes in porphyria cutanea tarda.
»What causes porphyria cutanea tarda?
»How is porphyria cutanea tarda diagnosed?
»How is variegate porphyria distinguished from porphyria cutanea tarda?
»What treatments are used in porphyria cutanea tarda?
»What are the cutaneous findings in erythropoietic protoporphyria?
»How is a diagnosis of erythropoietic protoporphyria made?
»What treatments are used in erythropoietic protoporphyria?
»Do any other medical problems occur in patients with erythropoietic protoporphyria?
»Name some other photorelated disorders.

 
 
 

Describe the cutaneous changes in porphyria cutanea tarda.

Porphyria cutanea tarda. Vesicles, crusts, and milia on the hand of a patient with alcohol-triggered PCT.
Fig. 17.7 Porphyria cutanea tarda. Vesicles, crusts, and milia on the hand of a patient with alcohol-triggered PCT.
Skin fragility with minor trauma is a common complaint, particularly over the dorsal fingers and hands. Skin lesions are usually found on the dorsal hands, fingers, and feet and sometimes on the face and upper trunk. Tense vesicles and bullae develop in these sites and heal with erosions, scarring, atrophy, milia, and pigmentary changes (Fig. 17-7). Hypertrichosis and thickened, sclerotic plaques may develop on the face and chest. Patients may not relate the skin changes to sun exposure, but on questioning, they often have a history of worsening in the summer months or following other periods of intense sun exposure.