What are the important questions to ask a patient with suspected photosensitivity? - How long does it take for the skin reaction to develop following light exposure? Some reactions (e.g., solar urticaria) occur within minutes following sun exposure, while others (e.g., chronic cutaneous lupus erythematosus) may take weeks to develop.
- Have you ever had a similar skin reaction to light? Some reactions (e.g., polymorphous light reaction) tend to be recurrent or seasonal, while others may be one-time events (e.g., photosensitive drug reaction).
- Is there a family history of similar skin reactions to light? Some photosensitive disorders are familial (e.g., erythropoietic protoporphyria) or occur more frequently in certain racial groups (e.g., actinic prurigo in Native Americans).
- What do you put on your skin? Numerous products (soaps, perfumes, sunscreens) may produce photoallergic contact dermatitis in some individuals.
- What medications do you take by mouth? Numerous drugs, both prescription and nonprescription, can occasionally produce photosensitive reactions.
- Are there any associated cutaneous symptoms? Pruritus is a typical complaint associated with certain diseases (such as photoallergic contact dermatitis), while pain or burning is more commonly associated with phototoxic disorders (e.g., erythropoietic protoporphyria).
- Do you have any other symptoms? Some photosensitive dermatoses are confined to the skin, while others (e.g., systemic lupus erythematosus) are associated with internal involvement.
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