Solar Keratosis/Sunburn

Solar keratosis (also known as actinic keratosis) and sunburn are two common skin conditions resulting from excessive exposure to ultraviolet (UV) radiation. While they share a common cause, their implications and management strategies differ significantly.

Solar Keratosis (Actinic Keratosis)

  • Diagnosis
    • Clinical Presentation: Rough, scaly patches on sun-exposed areas such as the face, ears, neck, forearms, and back of the hands. Lesions may be pink, red, or flesh-colored.
    • Dermatoscopy: Can help in assessing suspicious lesions.
    • Biopsy: Recommended if the lesion is atypical, to rule out squamous cell carcinoma.
  • Differential Diagnosis
    • Squamous Cell Carcinoma: Actinic keratosis can progress to this type of skin cancer.
    • Seborrheic Keratosis: Benign, warty lesions.
    • Basal Cell Carcinoma: Especially for pearly or ulcerated lesions.
    • Psoriasis or Eczema: Particularly for lesions on non-sun-exposed areas.
  • Management
    • Topical Treatments:
      • 5-fluorouracil
      • imiquimod
      • diclofenac
    • Cryotherapy: For individual lesions.
    • Photodynamic Therapy: For multiple lesions or field therapy.
    • Regular Skin Examinations: Due to the risk of progression to squamous cell carcinoma.
    • Sun Protection: To prevent new lesions.

Sunburn

  • Diagnosis
    • Clinical Presentation: Red, painful skin that feels hot to the touch. Severe cases may include blisters, severe pain, headache, fever, nausea, and fatigue.
    • History of Sun Exposure: Usually occurs within a few hours of excessive sun exposure.
  • Differential Diagnosis
    • Phototoxic Reactions: Due to medication or chemical exposure.
    • Polymorphous Light Eruption: A reaction to sunlight in people who have developed sensitivity.
    • Heat Rash or Prickly Heat: Can be confused with mild sunburn.
  • Management
    • Cool Compresses: To reduce pain and heat.
    • Aloe Vera or Moisturizers: To soothe the skin.
    • Hydration: To replace fluid loss and prevent dehydration.
    • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): For pain and inflammation.
    • Avoid Further Sun Exposure: Until the burn has healed.
    • Topical Corticosteroids: For severe sunburn (prescription-only).

Prevention (For Both Conditions)

  • Sun Protection: Use of broad-spectrum sunscreen with an SPF of 30 or higher.
  • Physical Barriers: Wearing hats, sunglasses, and protective clothing.
  • Avoiding Peak Sun Hours: Typically between 10 AM and 4 PM.
  • Regular Skin Examinations: Especially for individuals with a history of extensive sun exposure or solar keratosis.