Dermatitis solaris

Last Updated: 2022-03-11

Author(s): Anzengruber F., Navarini A.

ICD11: EJ40

Sunburn

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)
  • Clinic

  • Stratum spinosum: eosinophilic dyskeratotic cells
  • Upper corium: vascular dilatation
  • Perivascular, lymphohistiocytic infiltrates.
  • Facultative: focal cell necrosis, extensive epithelial necrosis or subepithelial bullae

General measures

  • Instruct about the importance of sun protection and skin cancer
  • Moist, cooling compresses, if necessary with tap water or also with antiseptic solution

Topical therapy

  • Lotio zinci
  • Topical steroids (bring rather little)
    • Momethasone cream 1x a day
    • Clobetasol propionate cream or spray 1x a day

Systemic therapy

  • 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.

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