Allergic to the Sun

In my mid 20's I began noticing my eye lids swelling / puffing up when I spent a lot of time in the sun.  My entire life I have suffered from exzema (eczema), allergies, and asthma.  Now I am 40 and the adverse reaction to the sun has gotten worse each year and can occur all over my body, with the most intense reactions occurring on my eye lids and face and neck.  I also experience nasty welts or rashes in the summer on my abdomen, waist line, upper thighs and arm pits - all of which are areas that are never exposed directly to the sun.  I have used a half dozen steroids or creams to attack these symptons to no avail.

I went back to my dermatologist in utter frustration with my conditions and inability to spend time out in the sun.  I can cover up my legs arms and body, but the outbreaks on my eye lids and face are unbearable.With my dermatologist, we decided to go on a 10 day course of prednisone to get my skin under control and then try Plaquinol (hydroxychlor) to see if it would help with my sensitivity to the sun.

Within 3 days of being on prednisone my skin was cleared up and I stopped taking it after about 5 or 6  days.  On about day 4 or 5 of the prednisone I went to the golf course to hit a bucket of balls.  I was out in the sun for 45 minutes.  It was a cloudy day and you couldn't even see the sun.  I wore my wide brimmed golf hat and sun glasses anyway - but forgot my sunscreen.  As I finished, I could feel the skin around my mouth stinging.  That night my eyelids started swelling up and were swollen for about 2-3 days - the worst break out I have probably ever had.

I spoke to my dermatologist to see if the prednisone could somehow enhance my reaction to the sun - he said it shouldn't.I have been taking the Hydroxychlor for over a month now and it hasn't done a dang thing.

As soon as I stopped the prednisone, the welts on my body started showing up and were getting worse - none of my ointments (protopic, cutivate, triamcinolone) seemed to offer any relief.

In an act of desperation, a friend told me about Tahitian Noni juice and I gave it a try.  Within 36 hours I noticed definite improvement with my rashes/welts, and within 5 days my body was cleared up - UNBELIEVABLE RESULTS.  I will be a user for the rest of my life.

I took some of my remaining prednisone this week  for a few days to try and resolve symptons on my head.  I went out in the yard this week for 45 minutes wearing my sun glasses and a new hat(by SundayAfternoons - the material has a UPF factor of 50). It's like a lamp shade with a curtain hanging in back. Once again I forgot my sunscreen, but didn't think I needed it with this monstrous hat. That night my eyelids started sweelling up and my face was all broken out.  The only common link between these 2 nasty breakouts is the prednisone.

Question 1) Could the prednisone be exaserbating my sensitivity to the sun?
and 2) What other treatments can I pursue since the hydroxychlor hasn't shown any improvements?

[Alan Rockoff, MD]

Prednisone does not enhance sun sensitivity.

Hydroxychloroquine is an appropriate treatment for sun sensitivity, but may have to be taken longer than a month to show results.

I advise you to speak with your dermatologist about evaluation for internal diseases which cause such sensitivity (most likely this has already been done.)  Also, in severe cases such as yours, inducing tolerance to the sun can be accomplished by progressive exposure to artificial ultraviolet light.  This is mostly done in medical centers.

I am not familiar with Tahitian Noni juice.

Best.

Dr. Rockoff