ETIOLOGY

Photosensitivity disorder is caused by the exposure to the sun and at times by exposure to the sun after
taking certain drugs or by interaction between the drug and sunlight. In certain cases, genetic or
metabolic diseases may also cause or aggravate the disorder.

It is caused by an abnormal reaction to some component of the electromagnetic spectrum of sunlight

and a chromophore (reactive compound) within the skin.

The electromagnetic spectrum ranges from cosmic rays, invisible rays called ultraviolet
radiation (UVR), through visible light, to infrared, microwaves and radio waves. UVR has
3 portions:

• UVC: ultrashort wavelength rays 200–290 nm that do not reach the earth’s
surface
• UVB: short-wavelength rays 290–320 nm that cause sunburn and tan
• UVA: longer wavelength rays 320–400 nm that cause tanning and also suppress immune
reactions in the skin

Medications: Some widely used medications, including antibiotics, nonsteroidal anti-inflammatory drugs
(NSAIDS), antihistamines and certain heart medicines and statins for lowering cholesterol, can make you
far more sensitive to sunlight than you’d usually be. Sun-sensitizing drugs can also aggravate existing
skin conditions. Check this detailed list of medications that have been connected with photosensitivity
reactions.

Diseases and medical conditions: Certain medical conditions and disorders, including
autoimmune diseases like HIV, and lupus can make you hypersensitive to UV rays.
Photosensitive disorders are common in patients with HIV affecting as many as 5% of all
people. Photosensitivity can cause significant distress, often healing with disfiguring
hyperpigmentation. Photosensitivity can herald a more serious underlying issue such as
porphyria cutanea tarda or pellagra.

Skin-care products: Certain ingredients in products you use to make your skin look better, such as
retinols, glycolic acid or benzoyl peroxide, remove the outermost layer of skin to fight fine lines or acne.
Brighteners like vitamin C may decrease the melanin in your skin, which acts as a natural defense against
the sun’s rays. These may cause photosensitivity and increase your chances of damage from UV
exposure. Being diligent about sun protection is crucial while using these products.

PATHOPHYSIOLOGY

Photosensitivity is caused by an abnormal reaction to a component of the electromagnetic spectrum of

sunlight and a chromophore (reactive compound) within the skin. Patients can be sensitive to one kind
of sunlight, for example only to ultraviolet radiation, ultraviolet A or B (UVA, UVB), or visible light, or to a
wider range of radiation. The most common photosensitivity is to UVA. Mainly, exposure to visible light
triggers porphyria.
The pathogenesis of photosensitivity in HIV is multifactorial. Ultraviolet (UV) radiation causes the
production of reactive oxygen species in the skin, resulting in DNA damage and cell destruction. Oxygen-
free radical scavenging pathways are dysfunctional in HIV because of a host of factors, including a
relative glutathione and thioredoxin deficiency, alterations in the dietary absorption of elements such as
vitamins and flavonoids, and liver damage secondary to medications. Certain medications such as
trimethoprim-sulphamethoxazole, non-steroidal anti-inflammatory drugs (NSAIDs) and antiretrovirals
can be photosensitising and may increase the risk of photodermatitis.

Reference:

Textbook: Integumentary Physical Therapy Ji-Whan Park, Dae-In Jung

https://dermnetnz.org/topics/photosensitivity#:~:text=Photosensitivity%20can%20be%20caused%20
by,to%20certain%20medications%20or%20toxins.

https://www.skincancer.org/risk-factors/photosensitivity/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842981/

https://www.ncbi.nlm.nih.gov/books/NBK431072/#:~:text=Photosensitivity%20is%20caused%20by%
20an,reactive%20compound)%20within%20the%20skin.