synonymSunburn(sunburn) generally refers to solar dermatitis
Solar dermatitis, also known as acute sunburn or sunburn, is an acute injury caused by strong light exposure to the skinSkin reaction, the skin of the affected part showsRedness and swelling, burning, pain, and evenBlister、Burning pain, SkinDesquamationSome patients will still have symptomsheadache、fever, nausea, vomiting and other systemic symptoms.
This disease is common in late spring and early summer, and is mainly found in children, women, skiers and water surface operators. The degree of symptoms is related to light intensity, exposure time, skin color, physique, etc.[1]
Alias
Sunburn、Acute sunburn
Common location
Face, neck, arm, back of hand and other parts
common symptom
General discomfort, fever, nausea, palpitations, etc
According to a foreign statistical survey, about 34% of people have at least one sunburn.
High risk population
The disease is prone to occur in people with light skin color, and is more likely to occur in children, women, skiers and water surface operators.
pathogeny
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On the one hand, the skin has received more than the toleranceUltraviolet radiationOn the other hand, it may be that the individual patient belongs to the skin prone to sunburn and is prone to sunburn after ultraviolet radiation.
Long term and long time exposure to high intensity ultraviolet radiation is a high risk factor for the disease.
Basic etiology
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The skin receives too much light,Exposure timeToo long.When the skin receives more than the toleranceultraviolet rays, it is easy to cause the disease.
UV is ultraviolet ray, which can be divided into UVA, UVB and UVC according to different wavelengths. The spectrum of action of this disease is mainly UVB. The erythema caused by UVA is bright red, the erythema caused by UVA is dark red, and UVC can cause pink erythema of the skin.
Occurrence mechanism: Ultraviolet radiation causes various cells in the human dermis to release inflammatory mediators, causing vascular dilatation and increased permeability in the dermis. This reaction can occur while receiving intense ultraviolet radiation. Patients can have instant erythema, and then there will be complex reactions involving multiple factors of nerve, blood vessel and body fluid, leading to the occurrence of delayed erythema.
Predisposing factors
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Excessive drinking may cause sunburn.
Skin that is too wet is more prone to erythema than dry skin.
Photosensitive drugs: patients exposed to tetracyclines (especially doxycycline), thiazide diuretics, sulfonamides, fluoroquinolones, non steroidal anti-inflammatory drugs, retinoids, etc. will increase the risk of sunburn.
symptom
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A few hours to more than ten hours after the patient received sunshine, bright red erythema with clear boundary may appear at the sunburn, and blister rupture and erosion may occur in severe cases.Subsequently, the erythema color gradually darkens, scaling occurs, and pigmentation or regression may be left. The patient may have a burning sensation or tingling sensation, which may affect sleep.
Typical symptoms
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Time of occurrence
It usually occurs within a few hours to more than ten hours after the sun exposure. Acute sunburn symptoms can also occur quickly after the sun is too strong or exposed to the sun.
Occurrence site
Exposed to the sun.
symptom
Bright red erythema with clear boundary may appear in the sunlit area, and blister rupture and erosion may appear in severe cases.
Subsequently, the erythema color gradually darkens, usually subsides within 3 to 7 days, and then appearsDesquamation, pigmentation or hypopigmentation may be left, and some patients only showSkin pigmentChanges, showing immediate orTardinessPigmented sunburn.
Patient feeling
The patient may feel burning or tingling, which may affect sleep.
course of disease
Those with mild symptoms will recover within 2-3 days, and those with severe symptoms will recover within about a week.
When the patient is exposed to strong light, there are signs of redness, blisters, erythema, erosion and other symptoms at the irradiation site. If there are itching, burning and other feelings, the patient should seek medical advice immediately.
When the patient has symptoms such as fever, headache, chills, fatigue, nausea, and general discomfort, he should seek medical advice immediately.
If the above symptoms are aggravated, intolerable or even palpitations, please call 120 for help.
Visiting department
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the skin department
Diagnostic basis
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Questions doctors may ask patients:
Whether there is exposure history;
How long has it been since the onset of the disease;
Before coming to the hospital, did you handle it at home and how;
Whether similar situations have occurred before;
Whether the skin color of the exposed part is darker than before;
Have you ever used any medicine;
What vegetables and fruits have you eaten recently.
The diagnosis of sunburn is usually simple.The doctor carefully examines the skin of the patient with symptoms, and can diagnose according to the typical clinical manifestations of the disease site and the patient's strong sunlight exposure history.Determine whether the patient has taken medicine recently, taken it or contacted the exposed partFuracoumarinThe experience of plants helps to clarify the cause of disease.
Relevant inspection
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physical examination
Visual diagnosis: observe the condition of the patient's whole body or local skin with naked eyes, and observe whether the skin has symptoms such as redness, swelling, blisters, skin scaling, etc.
Palpation: find out whether there is burning at the diseased part of the patient.
Supplementary Examination
Patch test: apply the prepared test solution to the skin with appropriate methods, and observe whether there is hypersensitivity reaction after a certain time. It is often used for clinical detection of hypersensitivity reaction and contact dermatitis.It is helpful for doctors to judge whether it is an allergic reaction, eliminate possible causes, and facilitate further treatment.
Light test: irradiate a small piece of skin of the patient with natural sunlight, and make differential diagnosis according to the manifestation of clinical reaction, which is helpful for doctors to judge, eliminate possible causes, and facilitate further treatment.
differential diagnosis
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This disease needs to be differentiated from the following diseases.
Excessive sunburn reaction
in usePhototoxicityDrug or localphotosensitizerExcessive sunburn reaction may occur after the substance. The clinical manifestation is similar to that of solar dermatitis, and the exposed part has tingling or burning sensation.It can be identified by knowing whether the patient has used phototoxic drugs and whether there are plants exposed to furacoumarin.
There are many idiopathic illuminancesskin disease（Photodermatosis）The clinical manifestations of the disease were similar to those of sunburn.Polymorphous solar eruption
The clinical manifestations are similar to those of sunburn, but polymorphous sunburn occurs hours or days after sunburnitchnaturepapuleAnd blisters, showingSymmetrical distributionIt will disappear after several days, and it is most serious in spring and early summer, and may recur in the next year.It can be differentiated according to the history and clinical manifestation of the disease.Solar urticaria
The clinical manifestation is similar to that of sunburn, but it is solarUrticariaAfter sun exposure, the wheal will appear and disappear within a few hours.Light test can be used to differentiate the diagnosis.useNatural sunlightIrradiation of small pieces of the patient's skin can cause erythema or wheal, which will subside rapidly after stopping irradiation, namely solar urticaria.Systemic lupus erythematosus
Erythema may also appear after exposure to the sun, mainly involving the sun exposed areas, arms and hands, but the skin at joints is often not affected. Skin biopsy can be used for identification, which requires professional judgment of doctors.Contact dermatitis
Contact dermatitisa stimulusHistory,Skin lesionIt occurs at the contact site and has nothing to do with sunlight. It can be identified according to whether there is a history of sunlight and exposure.
treatment
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Slight sunburn can subside by itself in a few days.
Treatment includes treatment for skinSymptomatic treatmentAnd pain control, mainly by local external medication, patients with systemic symptoms need oral medication.
General treatment
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For sunburnt parts, further contact and repeated exposure to the sun should be avoided to avoid infection or secondary damage.
For mild and moderate sunburn, aloe based gel and local moisturizing cream can be used to apply or wet compress to relieve pain and discomfort.
When blisters appear, gently bandage or cover with gauze to prevent infection and avoid breaking the blister, because breaking the blister will slow down the healing process and increase the risk of infection.
If the blister breaks, it should be washed carefully with mild soap and water, and then covered with a wet dressing, such as normal saline or gauze soaked with Vaseline.
When the blister breaks and the skin peels off, dry tissue pieces can be removed and applied with antiseptic ointment or hydrocortisone cream.
Drink more water to replenish body fluid and prevent loss.
Main treatment: for nasal congestion, insect bites, skin chaps, mild burns, burns, abrasions, sunburn and skin itching caused by colds and colds.
Drug contraindication: This product contains methyl salicylate, which is not suitable for long-term use by infants.This product should not be used in large areas.
Precautions for use of other drugs: Do not use them on skin ulcers.Avoid contact with eyes and other mucous membranes (such as mouth, nose, etc.).In case of burning, redness and swelling at the application site, stop taking the medicine, wash the local medicine, and consult a doctor if necessary.
Main treatment: for solar dermatitis, contact dermatitis, papular urticaria, eczema, neurodermatitis, seborrheic dermatitis, skin pruritus, acne, mosquito bites, etc.
Medication: external use.Dip a cotton ball in a proper amount of liquid medicine and apply it to the local affected area, and massage slightly for better effect.
Adverse reaction: the product is irritating to mucosa and skin lesions.
Drug contraindication: It is forbidden for patients with acute dermatitis with erosive exudation.
Drug contraindication: This product and other antipyretic, analgesic and anti-inflammatory drugs are prohibited.It is forbidden for patients with active gastrointestinal ulcer.
Precautions: This product is a symptomatic medicine, which should not be used for pain relief for more than 5 days, and antipyretic for more than 3 days. If the symptoms are not relieved, please consult a doctor or pharmacist.
Drug chemical name: Chlorphenamine Maleate Tablets
Main treatment: This product is applicable to skin allergies: urticaria, eczema, dermatitis, drug eruption, skin pruritus, neurodermatitis, insect bite, and solar dermatitis.It can also be used for allergic rhinitis, vasomotor rhinitis, drug and food allergy.
Medication: oral medication.
Adverse reactions: The main adverse reactions were lethargy, thirst, polyuria, sore throat, drowsiness, weakness, palpitations, skin ecchymosis and bleeding tendency.
Precautions: Do not drive a machine, car, boat, engage in aerial work, mechanical work, or operate precision instruments during taking medicine.
Main treatment: disinfectant and antiseptic, used to flush small wounds and mucous membrane.
Medication: external flushing or wet compress.
Adverse reaction: slight irritation occasionally.This product can see itching, rash, flushing, allergic reactions and other adverse reactions.
Drug contraindication: This product is forbidden for patients with large area of skin damage.
Precautions: If there is burning, itching, redness and swelling at the application site, stop taking the drug, wash the local drug, and consult a doctor if necessary.
Adverse reactions: long-term use can cause skin atrophy, telangiectasia, pigmentation and secondary infection.Allergic reaction is occasionally seen.
Drug contraindication: infectious dermatosis is prohibited.
Precautions for use of other drugs: it is not suitable for large area and long-term use;The symptoms are not relieved after 1 week of medication, please consult a doctor.
There is no evidence based treatment of the disease in traditional Chinese medicineMedical evidenceYes, but someTCM treatmentOr drugs can alleviate symptoms. It is recommended to go to a regular medical institution for treatment under the guidance of doctors.
prognosis
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self-healing
one kindSelf limiting disease, usually within a few days, it can disappear by itself.
The daily life management of the disease focuses on sunscreen and prevention of the disease through sunscreen.
Through avoiding light, wearing protective clothing and extensive application of spectrumsunscreen creamIt can also increase the skin's tolerance to sunlight under the guidance of doctors.
Home care
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Patients with sunburn should avoid further exposure to the sun to avoid infection and secondary sunburn.
Patients should seek shade or reduce light.
Infants less than 6 months old should avoid direct sunlight.
Avoid going out from 10:00 am to 2:00 pm in the time period with the strongest sunshine intensity every day. If you go out, you should do a good job of sunscreen. If you go out, you should wear protective clothing, such as long sleeves and wide brimmed hats, and apply spectral sunscreen with high sun protection coefficient as recommended by your doctor.
In case of sunburn dermatitis, try to wear loose and soft clothes to avoid rubbing the affected area, and use mild and non irritating cleaning products to clean the affected area.
The patient can make a summary by himself and observe whether the occurrence of dermatitis is related to the food, cosmetics, drugs, etc. contacted. If it is found to be related, it is better to avoid contact.
Daily life management
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diet
The disease generally has no dietary taboos. Normal diet is enough. The diet should be light and nutritious to ensure adequateprotein、vitaminEtc.incidentPlant solar dermatitis% of patients should avoid usingPhotosensitive food, such as celery, fennel, celery, grapefruit, etc.
motion
Moderate exercise to avoid overwork. Avoid rubbing the skin lesions during exercise. When the skin lesions are damaged, stop the exercise properly.
life style
It is enough to ensure normal living. Patients should have regular lifestyle and avoid fatigue.
Emotional psychology
Properly care about the psychology of patients, and seek the help of doctors when necessary.
Daily condition monitoring
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Observe the state of skin erythema, the degree of itching, and whether there are systemic symptoms. If there are serious systemic symptoms, seek medical advice immediately and take emergency measures.
Special precautions
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Avoid going out when the sun is strongStrengthen protective measuresIn terms of diet, it is also necessary to avoid usingPhotosensitive substanceFood, leading to increased possibility of the occurrence of the solar dermatitis.
prevention
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When the sun is sufficient, try to avoid outdoor activities from 10:00 a.m. to 2:00 p.m., or reduce the time for outdoor activities to avoid exposure to the sun.
Sunscreen can be applied on exposed parts or sunshade can be used, such as hats, long sleeved clothes, sunshade umbrellas, sunglasses and other items for protection.
If you are outdoors, it is recommended to use sunscreen with sun protection factor (SPF) above 15 routinely. If you have severe photosensitivity, you should use high-efficiency sunscreen with SPF greater than 30. The sunscreen should be used at least 20 minutes before the sun exposure.
Take part in outdoor sports to improve the skin's tolerance to sunlight.[1-7]
