This document discusses various skin conditions caused or aggravated by sun exposure. It begins by classifying conditions as either acute or chronic, then describes acute sunburn caused by UVB radiation damaging DNA. It also discusses phototoxic drug eruptions caused by drugs like amiodarone exacerbating sunburn through UVA damage. Photoallergic drug eruptions are allergic reactions to drugs like sulfonamides previously sensitized individuals experience with UVA. Chronic conditions include photoaging/dermatoheliosis causing premature aging, solar lentigos appearing as brown macules, and porphyria cutanea tarda a metabolic disorder causing fragile skin in exposed areas.

1. THE SUN & THE SKIN
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4. YETEKATETUT
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1 acute sun burn
2 phototoxic drug eraption
3 photo alergic drug eruption
4 photo aging (poor prognosis)
5 solar lentigo
6 pc tarda (alcohol, estrogin
iron,hemodialiss Dm, high Hcq will
worsin it)

5. CLASSIFICATION
Acute
– Sunburn
– Plant-induced
– Solar urticaria
– Idiopathic
– Actinic prurigo(pu
rigo itching main
symptom A for
acut)
Chronic
–Dermatoheliosis
–Chronic actinic dermatitis
–Solar lentigo
–Solar keratosis
–Skin cancer
–Metabolic and Nutritional
Disorders
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6. ACUTE SUN BURN
Acute, delayed, and transient
inflammatory(since dermatits)
response of the skin following
exposure to ultraviolet radiation
Caused by UVB
Damage to DNA with excision of
pyrimidine diamers is the initiating
event
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7. ACUTE SUN BURN
Pruritus may be severe even in
mild sunburn; pain and
tenderness with severe sunburn.
Constitutional symptoms may
occur
Confluent erythema, edema,
vesicles, and bullae confined
strictly to areas of exposure
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13. ACUTE SUN BURN
Cool wet dressings, topical
corticosteroids, NSAIDs like
indocid or Acetylsalcylic acid or
in severe cases short course oral
prednisolone 20 to 40 mg is used
Usually heals with out scaring
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14. PHOTOTOXIC DRUG ERUPTION
An exaggerated sunburn response
(erythema, edema, vesicles, etc.)
secondary to drugs
Amiodarone, thiazides, coal tar ,
doxycycline are some of the known
drugs (cat and dog in syphil also)
The damage is due to UVA
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15. PHOTOTOXIC DRUG ERUPTION
Three clinical patterns
 immediate erythema and urticaria,
 delayed sunburn-type pattern (sun
burn like to remeber)
 delayed melanin
hyperpigmentation
Treatment is the same as sun burn
Sun burn wosend by drug intake
malet new 15

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19. PHOTOALLERGIC DRUG
ERUPTION(THIS ARE SULFA
DRUG)
Occurs in small percentage of
individuals previously sensitized
with the drug , and they have
established memory cells.
Halogenated salicylanilides,
phenothiazines, sulfonamides with
UVA (ssp)are some of the causes
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20. PHOTOALLERGIC DRUG
ERUPTION
Resemble allergic contact
eczematous dermatitis and
pruritis is universal
Photopatch testing with the
suspected drug
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24. PHOTOALLERGIC DRUG
ERUPTION
Avoid all possible causes
Immunosupression with
azathipurine plus
glucocorticoids or oral
cyclosporine may be required.
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25. DERMATOHELIOSIS (PHOTOAGING)
A syndrome of polymorphic
response of various components
of the skin
Cumulative effect of chronic sun
exposure – UVA, UVB, VL, IR
More severe in fair skin individuals
presenting after 40 years of age.
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26. DERMATOHELIOSIS
Patient appears as wrinkled,
wizened, leathery,
“prematurely aged.
Other signs of chronic
photodamage may be
observed
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29. DERMATOHELIOSIS
Tretinoin,
5Fluorouracil(acne
melasma yakmal) and
sun screens may help.
Generally has poor
prognosis 29

30. SOLAR LENTIGO
A circumscribed brown macule
resulting from a localized
proliferation of melanocytes due
to chronic exposure to sunlight
Again more common in fair
skinned individuals
Cryosurgery and laser are
effective means of treatment
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35. PORPHYRIA CUTANEA TARDA
A photo aggravating metabolic
disorder that presents as “fragile
skin” of the exposed areas and at
times tense bullae
UROGEN decarboxylase
deficiency
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36. PORPHYRIA CUTANEA TARDA
Aggravated by alcohol,
estrogens, iron,
polychlorinated
hydrocarbons, high dose
chloroquine, diabetes
mellitus and hemodialysis
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39. PORPHYRIA CUTANEA TARDA
Avoid ethanol
Phlebotomy
Low dose chloroquine
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