[Photodermatoses during childhood]

Environmental dermatology in childhood: photosensitivity

Recently, sunlight-induced damage of healthy human skin, including skin malignancies and a large scale of photodermatoses representing a diverse group of diseases, have increased in childhood as a result of unfavorable environmental changes. This article yields an overview of the diagnosis, the clinical features and the treatment of these conditions and disorders and also reveals perspectives. Some diseases are more frequent in the pediatric population than in adulthood, whereas others heal spontaneously during adolescence and vice versa. The majority of cases are idiopathic photodermatoses, mainly polymorphic light eruption. Photosensitivity may be an early symptom of genetic disorders, such as porphyria, or very rare genophotodermatoses. Photosensitivity, secondary to topical or systemic external agents as well as photoexacerbated dermatoses, is not so frequent in childhood. Effective photoprotection is crucial.

Hereditäre Photodermatosen

Hereditary photodermatoses are characterized by an increased photosensitivity caused by an inherited single gene defect. With few exceptions, they manifest in early childhood, reveal heterogeneous clinical symptoms, and are difficult to treat. Although these diseases are rare, it is very important to make an accurate diagnosis on the basis of clinical symptoms, specific diagnostic tests, and direct DNA analysis. We review the spectrum of inherited photodermatoses, including porphyria cutanea tarda, erythropoietic protoporphyria, actinic prurigo, Kindler syndrome, and disorders associated with a defect in DNA repair, including xeroderma pigmentosum, trichothiodystrophy, Cockayne syndrome, and Bloom syndrome. Early diagnosis may prevent complications associated with prolonged unprotected exposure to sunlight and makes it possible to offer genetic counseling and, when indicated, prenatal diagnosis to families at risk for these rare heritable disorders.