$Unique_ID{BRK02347} $Pretitle{} $Title{What Are Causes of Terrible Skin Reactions?} $Subject{skin reaction reactions sun photosensitive photosensitivity sunlight burn burns solar light lights photochemical overexposure lupus erythematosus LE sunscreen sunscreens topical corticosteroid corticosteroids oral hydroxychloroquine dermatomyositis dm inflammatory rash rashes porphyria cutanea tarda pct} $Volume{L-20} $Log{} Copyright (c) 1992,1993 Tribune Media Services, Inc. What Are Causes of Terrible Skin Reactions? ------------------------------------------------------------------------------ QUESTION: Just when I thought I had gone through a summer without any health problems, I came down with a terrible skin reaction after but a few minutes in the sun. My whole body turned flaming red. Can you figure out what caused this? ------------------------------------------------------------------------------ ANSWER: You had a "photosensitive" reaction. That's the simple answer, but finding out why takes some evaluation by a doctor who is familiar with such problems. There are different reasons a person may have a very bad reaction to sunlight. Several medications cause people to react badly to the sun. Then there are skin diseases within the body that can cause your skin to burn with only a small amount of exposure to sunlight. Solar energy in large enough quantities can burn anybody, but in some individuals absorbed light in any amount may trigger a photochemical reaction, resulting in tissue damage. When you speak to a doctor and he or she rules out "normal" overexposure to the sun (think back, you might have been outside longer than you realized) it is time to start investigating further. The physician should get a full history of what medications you are on, did you drink alcoholic beverages while in the sun or just before exposure, did you wear perfume that could have triggered an allergic reaction? If there isn't a simple answer to what caused your severe burn, then it's time to do testing for diseases within the body that make the skin react. Lupus Erythematosus is a systemic disease that has been found to affect about 1 in 800 people in the United States, occurring primarily in women. Exposure to sunlight is a factor that seems to contribute to the development or onset of this disease. This chronic inflammatory disease can cause injury to the skin, joints, kidneys, nervous system and mucous membranes. It is possible to have flare-up periods and remissions with this disease, and LE patients are instructed to avoid exposure to sunlight as much as possible to minimize relapses. Naturally, it is impossible to avoid sunlight altogether, so it is imperative that LE patients use a sunscreen daily with a sun protection factor of at least 15. Patients are also treated with topical corticosteroids and, in rare cases, with oral hydroxychloroquine. Dermatomyositis (DM) is another inflammatory disease, characterized by skin rashes. DM may be complicated by lung disease, esophageal problems, cardiac conditions and arthritis. Myositis may cause progressive muscle weakness and tenderness. DM is also associated with an increased risk of cancer. Lab tests that should be done on DM patients include evaluation of blood in the stool, mammography and chest films. Another skin disease, porphyria cutanea tarda (PCT) is associated with alcohol abuse. PCT patients often show a striking improvement when they stop drinking. Estrogen therapy in postmenopausal women may also exacerbate this disease. If you haven't already been to a doctor about your strange reaction to the sun, go. As you can see, the skin rash could be a warning sign of a much greater problem. But if you are like many of my patients (and family), you probably just underestimated the time you spent sunbathing, and probably took your exposure when the suns rays where at their highest intensity. Let's hope so, for then your doctor's visit will be a fine educational visit, and you will have no serious worries to concern you. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.