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Photosensitive Dermatitis

»What is the definition of photosensitivity?
»What is the difference between a phototoxic reaction and a photoallergic reaction?
»What is the clinical appearance of a photodistributed eruption?
»Name some of the most common topical phototoxic and photoallergic agents and their action spectrums.
»Name some of the most common systemic phototoxic and photoallergic agents and their action spectrums.
»Give some examples of unique phototoxic reactions.
»What are some scenarios in which the skin may be more sensitive to ultraviolet radiation?
»What are the important questions to ask a patient with suspected photosensitivity?
»What are the most common causes of photosensitive dermatoses?
»What is persistent light reactivity?
»What is polymorphous light eruption (PMLE)?
»How is PMLE diagnosed?
»How is PMLE treated?
»What is actinic prurigo?
»What is solar urticaria?
»Discuss the differential diagnosis of photodermatoses in infants or young children.
»How do hydroa aestivale and hydroa vacciniforme differ?
»Which porphyrias are associated with photodermatoses?
»Describe the cutaneous changes in porphyria cutanea tarda.
»What causes porphyria cutanea tarda?
»How is porphyria cutanea tarda diagnosed?
»How is variegate porphyria distinguished from porphyria cutanea tarda?
»What treatments are used in porphyria cutanea tarda?
»What are the cutaneous findings in erythropoietic protoporphyria?
»How is a diagnosis of erythropoietic protoporphyria made?
»What treatments are used in erythropoietic protoporphyria?
»Do any other medical problems occur in patients with erythropoietic protoporphyria?
»Name some other photorelated disorders.

 
 
 

How is porphyria cutanea tarda diagnosed?

Fluorescent spectrophotometric analysis of plasma is a rapid screen for porphyria. Plasma is exposed to an excitation wavelength of 400 to 410 nm, and the emission peaks are measured. A sharp emission peak at 619 nm confirms a porphyrin disorder. To differentiate the specific porphyrins further, a 24-hour urine specimen is submitted for porphyrin studies. In PCT, the major porphyrins elevated in urine are uroporphyrin I and 7-carboxylporphyrin III. In addition, stool porphyrins should be tested; PCT patients have normal levels of protoporphyrins but increased isocoproporphyrins in the stool.