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Sunburn - Skin in Adult
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Sunburn - Skin in Adult

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Sunburn (solar erythema) is the skin's reaction to excessive ultraviolet light exposure. It presents as reddening and tenderness of the skin that typically appears 30 minutes to 8 hours after exposure and peaks between 12 and 24 hours after exposure. UVB radiation is much more potent than UVA at inducing erythema; the 300 nm wavelength within the UVB range is the most erythemogenic. Severe sunburn can evolve into edema, blistering, and desquamation, the latter of which occurs 4–7 days after the exposure as the erythema is fading. Extreme reactions may include systemic symptoms such as chills and malaise and may necessitate hospitalization and management similar to that for thermal burns. Sunburn incidence is increased in areas that are closer to the equator and higher in altitude. Sunburn occurs more frequently in fairer-skinned individuals and in younger age groups. Darker skin types are more resistant to photodamage due to increased epidermal melanin content and different melanosome dispersion patterns. Skin phototypes (Fitzpatrick classification) are classified on the basis of susceptibility to sunburn and ability to tan:

Skin Phototype:
I: Always burns, never tans
II: Frequently burns, rarely tans
III: Infrequently burns, usually tans
IV: Low susceptibility to sunburn, light brown skin color
V: Very low susceptibility to sunburn, brown skin color
VI: Extremely low susceptibility to sunburn, dark brown skin color

Although sunburn is self-limiting, there is morbidity and mortality associated with long-term sun exposure in the form of a heightened risk of skin cancer. 

Codes

ICD10CM:
L55.9 – Sunburn, unspecified

SNOMEDCT:
403194002 – Solar erythema

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Many drugs that are phototoxic and cause exaggerated sunburn are active in the UVA spectrum. UVA can pass through window glass that stops UVB (the usual wavelength for inducing skin cancer).

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 01/23/2015
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Sunburn - Skin in Adult
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Sunburn (Severe Sunburn) : Chills, Fever, Headache, Nausea, Erythema, Skin warm to touch, Sun exposure - recent intense, Sun-exposed distribution
Clinical image of Sunburn
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