Photodermatology

A 45-year-old woman was referred to dermatology with a 10-year history of severe photosensitivity. Brief sun exposure, including through windows and on cloudy days, triggered marked erythema that developed scaling within 24–48 hours and persisted for up to a week, without vesicles or blistering. She had Fitzpatrick skin type II and a background of atopic eczema and chronic hand dermatitis. Previous patch testing was positive for fragrance mix I and II. Long-term medications included bendroflumethiazide and ramipril, recently changed to candesartan. There was no known family history of photosensitivity.