Workup for Increased Sun Sensitivity

Initial Assessment

A detailed history focusing on timing and pattern of reactions, specific triggers, distribution of affected areas, associated symptoms, and family history of photosensitivity disorders is essential for diagnosis, according to the American College of Dermatology 1
Medication review is crucial as many drugs, including antibiotics, cardiovascular medications, and antidepressants, can cause photosensitivity, as noted by the American Heart Association 2

Documenting the distribution and morphology of lesions, including signs of chronic photodamage, is important for diagnosis, as recommended by the American Academy of Dermatology 1
Ocular involvement, such as photophobia and conjunctival injection, should be evaluated, according to the American College of Dermatology 1, 3

Basic laboratory studies, including complete blood count with differential and comprehensive metabolic panel, should be performed, as suggested by the British Association of Dermatologists 4, 3
Genetic testing for suspected xeroderma pigmentosum or other inherited photosensitivity disorders may be necessary, according to the American College of Medical Genetics 1, 3

Phototesting, including minimal erythema dose determination for UVA and UVB, should be performed by dermatology specialists, as recommended by the British Association of Dermatologists 4, 5
Minimum urticarial dose testing for suspected solar urticaria may be necessary, according to the British Association of Dermatologists 6, 7

Immediate measures, including discontinuation of suspected photosensitizing medications, sun protection with broad-spectrum sunscreens, and protective clothing, should be taken, as recommended by the American Academy of Dermatology 1, 3
Referrals to dermatology, ophthalmology, and genetics may be necessary for specialized management and evaluation, according to the American College of Dermatology 1, 4, 3, 6

Solar urticaria is characterized by the rapid onset of urticaria after sun exposure, affecting patients with this condition, according to the British Journal of Dermatology 8
Chronic actinic dermatitis is a persistent eczematous reaction in sun-exposed areas, as reported by the British Journal of Dermatology 8

The American Academy of Dermatology recommends sun protection with broad-spectrum sunscreens (SPF ≥30 that is labeled as broad spectrum) for patients with photosensitivity, as published in the Journal of the American Academy of Dermatology 9
The American Academy of Family Physicians suggests protective clothing, including broad-brimmed hats, long-sleeved shirts, and long pants, to prevent sun exposure, as stated in American Family Physician 10
Patients with photosensitivity should avoid peak sun hours (10 AM to 4 PM) and sunlamps and tanning beds, as advised by American Family Physician 10 and the Journal of the American Academy of Dermatology 9
The American Academy of Dermatology recommends regular skin self-examination and annual skin examinations by a dermatologist, especially for patients with chronic photosensitivity, as published in the Journal of the American Academy of Dermatology 9