Adverse reaction of sunlight on the skin

[apa108]

Hello all,
This is a unique case of a relative of mine who is overseas suffering with this skin disease which we along with many doctors have no idea what it is about. Details are
1- He is unable to go into sun .His skin starts itching and he feels extremely uncomfortable.
2-He cant even stay in warm/hot weather as He starts developing small bumps all over his skin especially areas which are exposed to direct sunlight. As a result he continously lives in Air conditioned environment.
He has been to many doctors over the past 2 years including some skin specialists and had many blood tests including STD and all , and so far nothing has been diagnosed. He is in a country where advanced technology as well as research is not so widely available so I am asking this here for any kind of suggestions ,ideas or tests that can be done. Any experiences on this discussion board .

[Bhupinder Kaur, MD]

Hello,
Solar urticaria is diagnosed by phototesting. For cholinergic urticaria, some physicians will perform skin testing to methacholine, a chemical that may cause a positive test in people with cholinergic urticaria.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[apa108]

Hi Dr Kaur,
I recently learnt that my relative has Higher Blood pressure problem which is possibly the reason for this skin issue. What are your thoughts on it ?

[apa108]

Thanks doctor for the input.Is there any blood test or skin test that could be done to confirm this?

[Bhupinder Kaur, MD]

Hello,
One possibility for such a rash is of solar urticaria. It is the development of hives minutes after exposure to the sun, which resolve in less than 1 hour.

Ask your relative to apply a good sunscreen with minimum spf 30 atleast half an hour before going out in the sun. He can take non-sedating antihistamines such as Cetirizine or Loratadine(Claritin) when the rash appears. Short courses of oral cortisone or steroids are taken for short periods (one to three days) to settle more severe symptoms. He may take Vitamin C along with the prescribed treatment. Vitamin C is a general anti-allergy supplement. Also apply calamine lotion and a mild steroid cream like dermacort on the rash.

To prevent solar urticaria in future, desensitization using phototherapy and photochemotherapy are often advised. In this we try to decrease the amount of exposure by gradually increasing exposure to the form of radiation that brings about the reaction.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[apa108]

Anyone ? Any ideas/experiences ?Any tests that could be done ?