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Evaluation of the Patient with Photosensitivity

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Allergy Frontiers: Diagnosis and Health Economics

Part of the book series: Allergy Frontiers ((ALLERGY,volume 4))

Photosensitivity encompasses a range of conditions characterised by altered sensitivity to solar ultraviolet (UV) and/or visible radiation. Photosensitivity disorders can be divided into four broad categories: (i) idiopathic/immune-based dermatoses; (ii) drug and chemically induced reactions, including exogenously mediated reactions and the cutaneous porphyrias; (iii) disorders associated with defects in DNA excision repair; (iv) photoaggravated dermatoses, a wide range of disorders that may be worsened by light exposure. Photosensitive individuals develop abnormal skin reactions following sunlight exposure, and these can be replicated by exposure to artificial light sources in the laboratory. Characterisation of the photosensitive patient includes clinical evaluation with detailed history including details of symptoms of onset and current medication. Phototesting, i.e. assessment of skin responses following application of defined wavelengths and doses of UVB, UVA and visible radiation provides information on the action spectrum of the disorder and permits clinical assessment of rash morphology. Associated tests including autoantibody screening, porphyrin fluorescence scanning and histocompatability locus antigen subtyping further assist in diagnosis.

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References

  1. Ros AM, Wennersten G (1986) Current aspects of polymorphous light eruptions in Sweden. Photodermatol 3:298–302

    PubMed  CAS  Google Scholar 

  2. Pao C, Norris PG, Corbett M, Hawk JL (1994) Polymorphic light eruption: prevalence in Australia and England. Br J Dermatol. 130:62–64

    Article  PubMed  CAS  Google Scholar 

  3. Ling TC, Richards HL, Janssens AS, Anastassopoulou L, Antoniou C, Aubin F, Diepgen TL, Fazakerley R, de Gruijl FR, Jansen CT, Pavel S, Smedley A, Stratigos AJ, Webb AR, Gibbs NK, Rhodes LE (2006) Seasonal and latitudinal impact of polymorphic light eruption on quality of life. J Invest Dermatol 126:1648–1651

    Article  PubMed  CAS  Google Scholar 

  4. Ling TC, Gibbs NK, Rhodes LE (2003) Treatment of polymorphic light eruption. Photodermatol Photoimmunol Photomed. 19:217–227

    Article  PubMed  CAS  Google Scholar 

  5. Epstein S (1942) Studies on abnormal human sensitivity to light I V. Photoallergic concept of prurigo aestivalis. J Invest Dermatol 5:289–298

    Google Scholar 

  6. Norris PG, Hawk JL (1990) Polymorphic light eruption. Photodermatol Photoimmunol Photomed 7:186–191

    PubMed  CAS  Google Scholar 

  7. Norris PG, Barker JN, Allen MH, Leiferman KM, MacDonald DM, Haskard DO, Hawk JL (1992) Adhesion molecule expression in polymorphic light eruption. J Invest Dermatol 99:504–508

    Article  PubMed  CAS  Google Scholar 

  8. Kolgen W, Van Weelden H, Den Hengst S, Guikers KL, Kiekens RC, Knol EF, Bruijnzeel-Koomen CA, Van Vloten WA, de Gruijl FR (1999) CD11b + cells and ultraviolet-B-resistant CD1a + cells in skin of patients with polymorphous light eruption. J Invest Dermatol 113:4–10

    Article  PubMed  CAS  Google Scholar 

  9. Palmer RA, Friedmann PS (2004) Ultraviolet radiation causes less immunosuppression in patients with polymorphic light eruption than in controls. J Invest Dermatol 122:291–294

    Article  PubMed  CAS  Google Scholar 

  10. Millard TP, Bataille V, Snieder H, Spector TD, McGregor JM (2000) The heritability of polymorphic light eruption. J Invest Dermatol 115:467–470

    Article  PubMed  CAS  Google Scholar 

  11. Rhodes LE (2004) Polymorphic light eruption reassessed. Arch Dermatol 140:351–352

    Article  PubMed  Google Scholar 

  12. Hawk JL, Magnus IA (1979) Chronic actinic dermatitis — an idiopathic photosensitivity syndrome including actinic reticuloid and photosensitive eczema. Br J Dermatol 101(Suppl 17):24

    PubMed  Google Scholar 

  13. Ferguson J (2006) Chronic actinic dermatitis. In: Ferguson J, Dover JS (eds) Photodermatology. Manson, London, pp. 39–43

    Google Scholar 

  14. Russell SC, Dawe RS, Collins P, Man I, Ferguson J (1998) The photosensitivity dermatitis and actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients. Br J Dermatol 138:496–501

    Article  PubMed  CAS  Google Scholar 

  15. Ogboli MI, Rhodes LE (2000) Chronic actinic dermatitis in young atopic dermatitis sufferers. Br J Dermatol 142:845

    Article  PubMed  CAS  Google Scholar 

  16. Yap LM, Foley P, Crouch R, Baker C (2003) Chronic actinic dermatitis: a retrospective analysis of 44 cases referred to an Australian photobiology clinic. Australas J Dermatol 44:256–262

    Article  PubMed  Google Scholar 

  17. Menage H du P, Ross JS, Norris PG, Hawk JLM, White IR (1995) Contact and photocontact sensitization in chronic actinic dermatitis: sesquiterpene lactone mix is an important allergen. Br J Dermatol 132:543–547

    Article  PubMed  CAS  Google Scholar 

  18. Fujita M, Miyachi Y, Horio T, Imamura S (1990) Immunohistochemical comparison of actinic reticuloid with allergic contact dermatitis. J Dermatol Sci 1:289–296

    Article  PubMed  CAS  Google Scholar 

  19. Menage H du P, Hawk JLM (1993) The red face: chronic actinic dermatitis. Clin Dermatol 11:297–305

    Article  PubMed  CAS  Google Scholar 

  20. Brandt R (1958) Dermatological observations on the Navaho reservation. AMA Arch Derm 77:581–585

    PubMed  CAS  Google Scholar 

  21. National Radiological Protection Board (2002) Health effects from Ultraviolet Radiation. Report of an advisory group on non-ionizing radiation. National Radiation Protection Board 13:162–190

    Google Scholar 

  22. Umana A, Gomez A, Duran MM, Porras L (2002) Lymphocyte subtypes and adhesion molecules in actinic prurigo: observations with cyclosporin A. Int J Dermatol 41:139–145

    Article  PubMed  CAS  Google Scholar 

  23. Arrese JE, Dominguez-Soto L, Hojyo-Tomoka MT, Vega-Memije E, Cortes-Franco R, Guevara E, Pierard GE (2001) Effectors of inflammation in actinic prurigo. J Am Acad Dermatol 44:957–961

    Article  PubMed  CAS  Google Scholar 

  24. Grabczynska SA, McGregor JM, Kondeatis E, Vaughan RW, Hawk JL (1999) Actinic prurigo and polymorphic light eruption: common pathogenesis and the importance of HLA-DR4/ DRB1*0407. Br J Dermatol 140:232–236

    Article  PubMed  CAS  Google Scholar 

  25. Frain-Bell W. (1985) The idiopathic photodermatoses. In: Frain-Bell W (eds) Cutaneous Photobiology. Oxford University Press, Oxford, pp 24–59

    Google Scholar 

  26. Rose RF, Bhushan M, King CM, Rhodes LE (2005) Solar angioedema: an uncommonly recognized condition? Photodermatol Photoimmunol Photomed 2005 21:226–228

    Article  CAS  Google Scholar 

  27. Beattie P (2006) Solar Urticaria. In Ferguson J. and Dover JS. (eds) Photodermatology. Manson Publishing, London, pp 45–50

    Google Scholar 

  28. Miyauchi H, Horio T (1995) Detection of action inhibition and augmentation spectra in solar urticaria. Dermatol 191:286–291

    Article  CAS  Google Scholar 

  29. Hawk JLM, Eady RAJ, Challoner AVJ, Kobza-Black A, Keahey TM, Greaves MW (1980) Elevated blood histamine levels and mast cell degranulation in solar urticaria. Br J Clin Pharmacol 9:183–186

    PubMed  CAS  Google Scholar 

  30. Soter NA, Wasserman SI, Pathak MA, Parish JA, Austen KF (1979) Solar urticaria release of mast cell mediators into the circulation after experimental challenge. J Invest Dermatol 72:282

    Google Scholar 

  31. Rajka E (1942) Passive transfer in light urticaria. Clin Immunol 13:327–345

    Google Scholar 

  32. Leenutaphong V, Holzle E, Plewig G (1989) Pathomechanisms and classification of solar urticaria: a new concept. J Am Acad Dermatol 21:237–240

    Article  PubMed  CAS  Google Scholar 

  33. Horio T, Hoelzle E (2007) Solar urticaria In: Lim HW, Hoenigsmann H, Hawk JLM (eds) Photodermatology. Informa Healthcare, New York

    Google Scholar 

  34. Magana M, Sangueza P, Gil-Beristain J, Sanchez-Sosa S, Salgado A, Ramon G, Sangueza OP (1998) Angiocentric cutaneous T-cell lymphoma of childhood (hydroa-like lymphoma): a distinctive type of cutaneous T-cell lymphoma. J Am Acad Dermatol 138:574–579

    Article  Google Scholar 

  35. Iwatsuki K, Xu Z, Takata M, Iguchi M, Ohtsuka M, Akiba H, Mitsuhashi Y, Takenoshita H, Sugiuchi R, Tagami H, Kaneko F (1999) The association of latent Epstein-Barr virus infection with hydroa vacciniforme. Br J Dermatol 140:715–721

    Article  PubMed  CAS  Google Scholar 

  36. Halasz CL, Leach EE, Walther RR, Poh-Fitzpatrick MB (1983) Hydroa vacciniforme: induction of lesions with ultraviolet A. J Am Acad Dermatol 8:171–176

    Article  PubMed  CAS  Google Scholar 

  37. Rhodes LE, White SI, (1998) Dietary fish oil as a photoprotective agent in hydroa vaccini-forme. Br J Dermatol 138:173–178

    Article  PubMed  CAS  Google Scholar 

  38. Elder GH (1999) The cutaneous porphyrias. In: Hawk JLM (ed) Photodermatology. Arnold, London, pp 171–197

    Google Scholar 

  39. Stenson PD, Ball EV, Mort M, Phillips AD, Shiel JA, Thomas NS, Abeysinghe S, Krawczak M, Cooper DN (2003) Human Gene Mutation Database (HGMD): 2003 update. Hum Mutat 21:577–581

    Article  PubMed  CAS  Google Scholar 

  40. Elder GH. (1990) The cutaneous porphyrias. Semin Dermatol 9:63–69

    PubMed  CAS  Google Scholar 

  41. Nacht S, San Martin de Viale LC, Grinstein M (1970) Human porphyria cutanea tarda. Isolation and properties of the urinary porphyrins. Clin Chim Acta 27:445–452

    Article  PubMed  CAS  Google Scholar 

  42. Korda V, Deybach JC, Martasek P, Zeman J, da Silva V, Nordmann Y, Houstkova, H, Rubin A, Holub J (1984) Homozygous variegate porphyria. Lancet 1:851

    Article  PubMed  CAS  Google Scholar 

  43. Gould JW, Mercurio MG, Elmets CA (1995) Cutaneous photosensitivity diseases induced by exogenous agents. J Am Acad Dermatol 33:551–573

    Article  PubMed  CAS  Google Scholar 

  44. Moore DE (2002) Drug induced cutaneous photosensitivity Incidence Mechanism Prevention and Management. Drug Safety 25:345–372

    Article  PubMed  CAS  Google Scholar 

  45. Ibbotson SH, Farr PM, Beck MH, Diffey BL, Ferguson J, George SA, Green C, Du P, Menage H, Murphy GM, Norris PG, Rhodes LE, White IR (1997) Workshop Report. Photopatch testing; methods and indications. Br J Dermatol 136:371–376

    Article  Google Scholar 

  46. Kraemer KH, Lee MM. Scotto J (1987) Xeroderma Pigmentosum. Cutaneous ocular and neurological abnormalities in 830 published cases. Arch Dermatol 123:241–250

    Article  PubMed  CAS  Google Scholar 

  47. Johnson RE, Kondratick CM, Prakash S, Prakash L (1999) hRAD30 mutations in the variant form of xeroderma pigmentosum. Science 285:263–265

    Article  PubMed  CAS  Google Scholar 

  48. Norris PG, Lehmann AR (1999) The repair deficient photodermatoses. In: Hawk JML (ed) Photodermatology. Arnold, London

    Google Scholar 

  49. Nance MA, Berry SA (1992) Cockayne syndrome: review of 140 cases. Am J Med Genet 42:68–84

    Article  PubMed  CAS  Google Scholar 

  50. Deng JS, Sontheimer RD, Gilliam JN (1984) Relationships between antinuclear and anti-Ro/SS-A antibodies in subacute cutaneous lupus erythematosus. J Am Acad Dermatol 11:494–499

    Article  PubMed  CAS  Google Scholar 

  51. Werth VP, Honigsmann H (2007) Photoaggravated dermatoses. In: Lim HW Honigsmann H, Hawk JLM (eds) Photodermatology. Informa Healthcare, New York, pp 251–266

    Google Scholar 

  52. Sanders CJ, Van Weelden H, Kazzaz GA, Sigurdsson V, Toonstra J, Bruijnzeel-Koomen CA (2003) Photosensitivity in patients with lupus erythematosus: a clinical and photobiological study of 100 patients using a prolonged phototest protocol. Br J Dermatol 149:131–137

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Photobiology Unit, Dermatological Sciences, University of Manchester, Salford Royal Foundation Hospital, Stott Lane, Manchester, M6 8HD, UK

    Ann K. Haylett & Lesley E. Rhodes

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  1. Ann K. Haylett
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  2. Lesley E. Rhodes
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Editors and Affiliations

  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. Southampton General Hospital, University of Southampton, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. UMKC School of Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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Haylett, A.K., Rhodes, L.E. (2009). Evaluation of the Patient with Photosensitivity. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Diagnosis and Health Economics. Allergy Frontiers, vol 4. Springer, Tokyo. https://doi.org/10.1007/978-4-431-98349-1_22

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  • DOI: https://doi.org/10.1007/978-4-431-98349-1_22

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-98293-7

  • Online ISBN: 978-4-431-98349-1

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