Treatment

Seek specialist advice.

Mild reactions are treated by avoidance of strong sunlight and the use of a broad spectrum sunscreen. However, this may limit outdoor activities and be socially unacceptable.

Severe cases may be treated with a controlled desensitisation course using phytochemotherapy (a combination of topical or oral psorales followed by UVA cubicle exposure - PUVA) or phototherapy (UVB) before the summer season. This thickens and pigments the skin so enhancing "natural" protection.

In the acute symptomatically debilitating case, a topical steroid is of benefit. If there is substantial disability, a short course of prednisolone (30mg/day for 5-7 days) may be useful (1). If severe pruritus present, anti-histamine should be used. In recalcitrant cases, hydroxychloroquine may be of some benefit (2).

Reference:

• (1) Morison WL. Photosensitivity. N Engl J Med. 2004;350(11):1111-7.
• (2) Wenner C et al. A bright red pruritic rash on the forearms. J Fam Pract. 2007;56(8):627-9
• (3) Am J Clin Dermatol. 2002;3(4):239-46