Last Updated: 2022-03-11
Toxic dermatitis, more precisely a prostaglandin-mediated reddening of the skin after UV exposure. People with fair skin types are particularly susceptible to sunburns.
Up to 40% of all people suffer at least one sunburn per year, younger people even more frequently.
- Most erythema is produced between 295- 315nm wavelength. Thus, the risk for sunburn is highest here.
- The rays cause subepithelial vascular dilatation and damage to keratinocytes. There is induction of apoptosis.
- At the sea and in the high mountains, UV-absorbing dust and haze particles are absent, reflections of the UV rays occur through water and snow, so that sunburn can occur more quickly than usual.
- First symptoms after 4 h, the peak is reached after approx. 12-24 h. During this time, a two-dimensional erythema develops. Subepithelial blisters may also appear.
- The skin changes subside with crusting and/or, in the case of minor sunburn, coarse lamellar scaling and, in a few cases, hyperpigmentation.
- General symptoms such as fever, heat sensation, exsiccation and ↓ blood glucose levels may occur with large skin involvement.
- Anamnesis ( sun exposure)
- Stratum spinosum: eosinophilic dyskeratotic cells
- Upper corium: vascular dilatation
- Perivascular, lymphohistiocytic infiltrates.
- Facultative: focal cell necrosis, extensive epithelial necrosis or subepithelial bullae
- Instruct about the importance of sun protection and skin cancer
- Moist, cooling compresses, if necessary with tap water or also with antiseptic solution
- Lotio zinci
- Topical steroids (bring rather little)
- Momethasone cream 1x a day
- Clobetasol propionate cream or spray 1x a day
- NSARs help against the pain and have some logic in prostaglandin mediation of erythema solare
- In exceptional cases, if symptoms are severe, oral glucocorticoids may be used for a short time
- Prednisolone p.o. 0.5- 1 mg per kg bw 1x daily
- Acetylsalicylic acid p.o. 100 mg 1x tgl.
- McLean DI, Gallagher RP. “Sunburn” freckles, café-au-lait macules, and other pigmented lesions of schoolchildren: The Vancouver Mole Study. Journal of the American Academy of Dermatology 1995;32:565-70.
- Wook Lee SKAEHCI. Inflammatory Linear Verrucous Epidermal Naevus Arising on a Burn Scar. Acta Dermato-Venereologica 1999;79:164-5.
- Naldi L, Lorenzo Imberti G, Parazzini F, Gallus S, La Vecchia C. Pigmentary traits, modalities of sun reaction, history of sunburns, and melanocytic nevi as risk factors for cutaneous malignant melanoma in the Italian population. Cancer 2000;88:2703-10.
- Pharis DB, Zitelli JA. Sunburn, Trauma, and the Timing of Biopsies of Melanocytic Nevi. Dermatologic Surgery 2001;27:835-6.
- Davis KJ, Cokkinides VE, Weinstock MA, O'Connell MC, Wingo PA. Summer Sunburn and Sun Exposure Among US Youths Ages 11 to 18: National Prevalence and Associated Factors. PEDIATRICS 2002;110:27-35.
- Geller AC, Colditz G, Oliveria S, et al. Use of Sunscreen, Sunburning Rates, and Tanning Bed Use Among More Than 10 000 US Children and Adolescents. PEDIATRICS 2002;109:1009-14.
- Thieden E, Philipsen PA, Sandby-Møller J, Wulf HC. Sunburn Related to UV Radiation Exposure, Age, Sex, Occupation, and Sun Bed Use Based on Time-Stamped Personal Dosimetry and Sun Behavior Diaries. Arch Dermatol 2005;141.
- Rhodes LE, Gledhill K, Masoodi M, et al. The sunburn response in human skin is characterized by sequential eicosanoid profiles that may mediate its early and late phases. The FASEB Journal 2009;23:3947-56.