Title: Allergy to Sunlight: A Rare Case of Solar Urticaria Raises Concerns
Subtitle: Patient’s reaction to the sun proves to be more than just a simple sunburn
Date: [Insert Date]
Orange, Conn. – A man in his 80s recently discovered that he had developed a rare allergy to sunlight, known as solar urticaria. The unusual reaction, characterized by an itchy rash and reddened skin, has left him searching for answers and adopting precautionary measures to remain protected from the sun’s harmful rays.
His journey to a proper diagnosis began when he noticed his skin turning bright pink after spending time outdoors. Suspecting a sunburn, he consulted with his dermatologist, Dr. Jeffrey M. Cohen, during his annual skin exam. However, his symptoms did not match the classic signs of sunburn that his wife experienced in the past.
Determined to find an explanation, the man scheduled another appointment with Dr. Cohen and strategically timed it during winter. He bared his chest, which had turned bright red, to show the doctor the effects of his unique reaction to sunlight. Intrigued by the patient’s case, Dr. Cohen suspected a photodermatitis, an inflammatory skin reaction triggered by exposure to light.
Further investigation led Dr. Cohen to classify the man’s reaction as a photoallergic dermatitis, where sunlight causes hives. These raised patches of intensely itchy and red skin usually take one to two days to appear after exposure to light. Dr. Cohen discovered the allergy was most likely triggered by the patient’s medication, hydrochlorothiazide, a blood pressure medicine.
A biopsy confirmed Dr. Cohen’s suspicions, confirming that the man had developed hives medically known as urticaria. He was advised to discontinue hydrochlorothiazide under the guidance of his primary care doctor. In a few weeks, the rash was expected to subside.
However, when the patient returned for a follow-up appointment, he revealed that the rash had not improved. Even sunlight coming through his window caused his skin to turn red and itchy. Dr. Cohen realized that the initial diagnosis was correct – the patient had developed an allergy to sunlight referred to as solar urticaria.
Solar urticaria is a rare disorder where the body has an immediate allergic reaction to specific cellular components that are altered by sunlight, particularly UVA light. Unlike sunburns caused by UVB light, solar urticaria can manifest even when sunlight penetrates through windows.
To manage his condition, the patient was instructed to use a high SPF sunscreen routinely, even when indoors. He also needed to increase his antihistamine dosage to alleviate symptoms. Wearing protective clothing, such as long sleeves, pants, and a hat, was advised to prevent extensive exposure. Severe reactions could potentially lead to anaphylaxis, a life-threatening allergic response.
Although the patient has adapted to these new precautions and developed a routine to protect himself from sunlight, he relies on his vigilant wife to alert him when he starts to turn red. Solar urticaria is a lifelong condition and remains difficult to treat.
Dr. Lisa Sanders, a contributing writer for the magazine, who covered the patient’s case, suggests that advancements in understanding and managing this rare condition will hopefully provide better options for those affected by solar urticaria.
For more medical mysteries and breakthroughs, Dr. Sanders’ latest book, “Diagnosis: Solving the Most Baffling Medical Mysteries,” offers a fascinating collection of compelling medical stories.
To share your own solved medical case, readers can reach out to Dr. Sanders via email at [email protected].
Note: This article is based on a real medical case, but the patient’s identity has been protected for privacy purposes.