Fotodermatozy to grupa schorzeń, w których czynnikiem wywołującym lub nasilającym objawy jest światło. Szczególnym typem fotodermatoz są fotodermatozy idiopatyczne, w których nadwrażliwość na światło to jedyny określony czynnik patogenny.
Do fotodermatoz idiopatycznych zalicza się przede wszystkim wielopostaciowe osutki świetlne (polymorphic light eruption, PLE), pokrzywkę słoneczną oraz przewlekłe zmiany posłoneczne (chronic actinic dermatitis, ChAD).
Wielopostaciowe osutki świetlne (PLE)
Do odmian klinicznych wielopostaciowych osutek świetlnych zalicza się świerzbiączkę letnią oraz opryszczkę ospówkowatą.
Do objawów świerzbiączki letniej należą zmiany rumieniowe, grudki i pęcherze, którym towarzyszy świąd. Pojawiają się w okresie wiosennym w czasie od kilku do kilkudziesięciu godzin od ekspozycji na promieniowanie słoneczne. Choroba częściej rozwija się u kobiet. Pierwsze symptomy można zaobserwować już w dzieciństwie.
Opryszka ospówkowata to rzadkie schorzenie. Objawia się występowaniem na odsłoniętej skórze pęcherzy i strupów krwotocznych, które mogą ulegać wtórnemu zakażeniu. W takim wypadku goją się one z pozostawieniem blizn. W przebiegu choroby mogą także występować objawy oczne (zapalenie spojówek, zapalenie rogówki) oraz objawy ogólne (gorączka).
Pokrzywka słoneczna
To rzadka choroba, która dotyka przede wszystkim osoby dorosłe. Zmiany skórne pojawiają się już w ciągu kilku minut po ekspozycji na słońce i obejmują rumień, pieczenie oraz bąble pokrzywkowe. W rzadkich przypadkach może się rozwinąć obrzęk naczyniowy. Pokrzywka słoneczna ma charakter przewlekły. Objawy mają niewielką tendencję do samoistnego ustępowania.
W leczeniu pokrzywki miejscowej stosuje się terapię miejscową (filtry przeciwsłoneczne), leki przeciwhistaminowe w dużych dawkach oraz fototerapię. W niektórych przypadkach skuteczność wykazuje stosowanie plazmaferezy.
Przewlekłe zmiany posłoneczne (ChAD)
Do ChAD zalicza się m.in. przetrwałe odczyny świetlne, wypryski z nadwrażliwością na światło oraz actinic reticuloid. Schorzenia te występują u osób cierpiących na przetrwałe uczulenie na substancje fotoalergizujące. Objawy rozwijają się w następstwie ekspozycji na promieniowanie nadfioletowe UVB i UVA.
Wyprysk z nadwrażliwością na światło występuje pod postacią ostrego lub podostrego wyprysku ze zmianami w miejscach odkrytych. Jeżeli objawy skórne mają charakter przewlekły, schorzenie określa się jako przetrwałe odczyny świetlne.
Actinic reticuloid to choroba schorzenie przewlekłym charakterze, które dotyka w większości przypadków mężczyzn po 60. roku życia. W przebiegu choroby dochodzi do zapalenia skóry z nasiloną lichenizacją w zajętych chorobowo obszarach, występują także zmiany naciekowe z limfocytów atypowych przypominające chłoniaki.
Leczenie ChAD obejmuje stosowane zewnętrznie filtry przeciwsłoneczne, beta-karoten, naświetlania PUVA, w niektórych przypadkach stosuje się także imuran i cyklosporynę A.
Źródła: http://www.dermatopedia.pl/, https://www.sluzbazdrowia.com.pl/
Przeczytaj także: Martwica skóry wywołana warfaryną – groźne powikłanie terapii przeciwzakrzepowej
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