Pediatric photosensitivity

Abstract

Summary Photosensitivity is a rarely encountered problem in the pediatric population. It may be caused by a diverse group of primary, idiopathic photosensitivity conditions, or may reflect photoexacerbation of an existing dermatosis. In addition, there are several genodermatoses, metabolic disorders, and connective tissue disorders that can present with photosensitivity, usually in addition to other extracutaneous clinical and laboratory findings. It is important that both dermatologic and pediatric practitioners be able to recognize the various causes of photosensitivity, as well as be familiar with the associated stigmata and necessary workup, if needed, of each particular disorder. This review offers an approach to the pediatric patient who presents with photosensitivity, with emphasis on arriving at the proper diagnosis, necessary evaluations, and management strategies.

Porfirias Cutâneas Em Idade Pediátrica

“…O choro associado à exposição solar pode ser a única manifestação em idades precoces. 28 A sensação de queimadura acompanha-se de eritema e edema difusos das áreas expostas que podem evoluir para lesões de urticária, purpúra e equimoses. As lesões vesiculares ou bolhosas são raras.…”

“…A doença colestática e a insuficiência hepática, complicações mais graves, ocorrem em menos de 5% dos casos embora alguns deles tenham necessidade de transplante hepático. 28,30 O diagnóstico diferencial desta fotossensibilidade que ocorre minutos após a exposição solar é feito com a urticária solar e a síndrome de Smith-Lemli-Opitz (síndrome polimalformativa resultante de um défice metabólico da biossíntese do colesterol caracterizado por dismorfias craniofaciais, anomalias congénitas de vários órgãos, restrição de crescimento intra-uterino, alterações comportamentais e défice cognitivo).…”

Update on pediatric photosensitivity disorders

“…following ultraviolet (UV) A or B light exposure, and pruritus is a key accompanying symptom of the eruption. Juvenile spring eruption (JSE), so named due to its nearly exclusive occurrence in children and predilection for onset in the spring, is considered by many experts to be a variant of PMLE [3,14]. Laboratory workup will show negative autoimmune lupus serologies and porphyrin studies, but it need not be performed in straightforward cases.…”

“…This may refer to the development of a new rash, aggravation of an existing dermatosis, or the experience of subjective symptoms of pruritus or paresthesias following exposure to sunlight or an artificial light source [2]. A diverse group of conditions may cause photosensitivity, and several such disorders can present at an early age, whereas others may preferentially affect the pediatric population [3][4]. In one of the largest studies examining the epidemiology of photosensitivity, over 25% of cases were reported to begin at or before 15 years of age [5].…”

“…Of these affected children, the majority was diagnosed with polymorphous light eruption (PMLE), the most common idiopathic photodermatosis [6]. Although photosensitivity is more rare in children than in adults, pediatric photosensitivity is unique in that several genodermatoses and metabolic disorders may present with the symptom of photosensitivity, thus making their early recognition of the utmost importance in the prevention of morbidity or even mortality from the disease [3][4].…”