1.3.3 Sunburn

Grading & Level of Importance: A




Solar dermatitis.


Very often to be observed during leisure time and vacation in sun rich areas, i.e. when no or inappropriate sun protection is available or used. 


Acute toxic photo- dermatitis caused by electromagnetic radiation in UVB range (280-320 nm). Unphysiologically high UVA doses can elicit an erythema too.

Aetiology & Pathogenesis

Acute dermatitis caused by erythematogenic doses of UVB radiation, more common in fair-skinned patients (Fitzpatrick skin types I-II). More severe cases result in release of proinflammatory cytokines (IL-6) and prostaglandins (PGE2), leading to systemic symptoms.

Signs & Symptoms

Short after overexposure to UVB prickling, itching and burning. Depending on dose and exposure time and latitude within 12 to 24 hours erythema. In severe courses with blistering and pain. Fever. 


In areas exposed to light.


1st degree: burning, erythema, desquamation.
2nd degree: blisters, weeping, crusts.
Rarely 3rd degree: necrosis.

Laboratory & other workups

Unremarkable. Increased CRP.


Apoptosis and necrosis of epidermal keratinocytes. Langerhans cell dysfunction and decrease in numbers. Edema. Submicroscopically mutations by cyclobutan dimers. 


Highly variable clinical appearance (just as in acute dermatitis): erythema, vesicles or blisters, weeping, crusts, scales. When severe, fever and malaise. Complete spontaneous healing.


Frequent sunburns, especially in childhood, lead to increased numbers of melanocytic naevi and an increased risk of malignant melanoma later in life.


By case history and clinical picture. 

Prevention & Therapy

Within the first 12 hours nonsteroidal anti-inflammatory drugs and class 3 antihistamines with effects on leucotrienes combined. Cooling topical agents (lotions, cold creams), wet dressings, later topical or systemic corticosteroids. Fluid.


Solar injury to brain with complications and edema need hospitalization especially in children. 

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