Skin Reactions to Cold and Heat Exposure

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Questions and Answers

What is a common characteristic of cutaneous reactions to abnormal cold exposure?

Always leads to severe skin damage

Can happen to anyone overexposed to excessive cold (correct)

Is primarily seen in athletes

Only occurs in individuals with pre-existing skin conditions

Which factor is essential for developing a cutaneous reaction to cold?

Genetic predisposition

Excessive cold exposure (correct)

Use of moisturizers

Exposure to warm climates

Who is most likely to experience cutaneous reactions to cold?

Individuals with a high tolerance to cold

Anyone exposed to excessive cold (correct)

Only those with a history of frostbite

People living in tropical regions

What conclusion can be drawn about cutaneous reactions to cold exposure?

They can manifest even in healthy individuals Signup and view all the answers

What distinguishes normal skin responses from cutaneous reactions to excessive cold?

Normal responses are temporary and harmless Signup and view all the answers

Which wavelength range is primarily responsible for causing sunburn?

290–320 nm Signup and view all the answers

What is a common cause of miliaria?

Blockage of sweat gland pores Signup and view all the answers

What is a potential consequence of UV exposure aside from immediate pigment darkening?

Premalignant and malignant skin conditions Signup and view all the answers

What treatments may improve the appearance of abnormally pigmented skin?

Topical tretinoin or laser therapy Signup and view all the answers

Immediate pigment darkening is primarily associated with which type of UV radiation?

UVA Signup and view all the answers

What is the primary characteristic of erythema ab igne?

It involves persistent redness of the skin Signup and view all the answers

Which reaction is NOT typically caused by UVB radiation?

Immediate pigment darkening Signup and view all the answers

What is the wavelength range of UVC radiation?

200–290 nm Signup and view all the answers

Which statement regarding abnormally pigmented skin is correct?

It may persist for years Signup and view all the answers

What is the expected outcome of treating sweat gland blockage?

Improvement of the sweat rash Signup and view all the answers

What is immediate pigment darkening and when does it occur?

It begins within minutes and lasts for several hours after sun exposure. Signup and view all the answers

Which of the following is NOT a type of skin cancer mentioned?

Melanoma skin disease Signup and view all the answers

Which skin condition is characterized as a precursor to skin cancer?

Actinic keratosis Signup and view all the answers

What is a common characteristic of basal cell carcinoma?

It typically does not metastasize. Signup and view all the answers

Which type of skin cancer is considered the least common but most deadly?

Malignant melanoma Signup and view all the answers

What is the primary reason for performing a skin biopsy in the presence of a persistent sore or growing lump?

To rule out the possibility of skin cancer Signup and view all the answers

What characteristics of a sore or lump may indicate the need for a skin biopsy?

A persistent sore that does not heal Signup and view all the answers

Which of the following is NOT a potential sign of squamous cell carcinomas?

Rapidly healing wound Signup and view all the answers

Which type of cancer is specifically mentioned in relation to persistent sores and lumps?

Squamous cell carcinoma Signup and view all the answers

What action should be taken if a patient has a growing lump within a rash?

Perform a skin biopsy Signup and view all the answers

What triggers the painful inflammatory lesions known as chilblains?

Exposure to cold Signup and view all the answers

In which age group are chilblains most commonly observed?

Older children and young adults Signup and view all the answers

What is a common characteristic of frostbite?

It is an abnormal reaction to usual cold exposure. Signup and view all the answers

Which of the following best describes the nature of the lesions caused by perniosis?

Painful inflammatory lesions Signup and view all the answers

What physiological response characterizes the condition of perniosis?

Abnormal vascular response to cold exposure Signup and view all the answers

Which of the following describes a potential cause of frostbite?

Genetic predisposition. Signup and view all the answers

What are examples of conditions related to frostbite?

Cryoglobulinemia and chilblain. Signup and view all the answers

What is the primary cause of chilblains?

Sudden temperature changes Signup and view all the answers

What is the primary aspect that differentiates those who experience frostbite?

Genetic susceptibility. Signup and view all the answers

Frostbite predominantly occurs in which of the following groups?

A small genetically predisposed population. Signup and view all the answers

Which skin condition is associated with UVB exposure and has premalignant potential?

Poikiloderma of Civatte Signup and view all the answers

What distinguishes senile comedones from other skin conditions?

Formation of small dark bumps Signup and view all the answers

Which skin condition is primarily related to UV exposure and typically manifests as red, spider-like veins?

Telangiectasia Signup and view all the answers

What is the primary cause of miliaria profunda?

Blockage at or below the dermo-epidermal junction Signup and view all the answers

What is a common characteristic of the papules associated with miliaria profunda?

They are flesh-colored and firm Signup and view all the answers

What is a key factor in the formation of solar elastosis?

Chronic UV exposure Signup and view all the answers

What is the recommended treatment for miliaria profunda?

Avoidance of hot exposure Signup and view all the answers

Which condition is NOT classified as a result of UVB exposure?

Peeling skin syndrome Signup and view all the answers

After experiencing repeated episodes of miliaria rubra, what complication may arise?

Development of miliaria profunda Signup and view all the answers

What distinguishes miliaria profunda from other forms of miliaria?

Location of the blockage at the dermo-epidermal junction Signup and view all the answers

What distinguishes phototoxic reactions from photoallergic reactions?

Photoallergic reactions typically have a longer onset time. Signup and view all the answers

Which of the following agents is NOT commonly associated with photosensitivity reactions?

Naproxen Signup and view all the answers

Which feature is characteristic of photoallergic reactions compared to phototoxic reactions?

They may spread to unexposed areas of skin. Signup and view all the answers

What type of immune response is associated with photoallergic reactions?

Type IV hypersensitivity Signup and view all the answers

How does the amount of agent required for phototoxic reactions compare to photoallergic reactions?

Phototoxic reactions require larger amounts. Signup and view all the answers

diseases aggrevated by sunlight

actinius lichen planus erythema multiforme lupus Signup and view all the answers

Which of the following is a metabolic disease associated with abnormal reactions to sun exposure?

Xeroderma pigmentosum Signup and view all the answers

Solar urticaria is an example of a drug-induced photodermatosis.

False Signup and view all the answers

Name one disease that is aggravated by sunlight.

Lupus erythematosus Signup and view all the answers

______ is a type of idiopathic photodermatosis characterized by an allergic response to sunlight.

Solar urticaria Signup and view all the answers

Match the following conditions with their categories:

Porphyria = Metabolic disease Actinic lichen planus = Disease aggravated by sunlight Chronic actinic dermatitis = Idiopathic photodermatosis Erythema multiforme = Disease aggravated by sunlight Signup and view all the answers

What systemic treatment may be indicated for severe cases of perniosis?

Oral nifedipine Signup and view all the answers

Which treatment is specifically aimed at improving skin texture in erythema ab igne?

Topical retinoids Signup and view all the answers

What is the primary cause of miliaria (heat rash)?

Blocked sweat glands Signup and view all the answers

Which of the following is NOT a part of the immediate care for phototoxic reactions?

Application of cortisone ointment Signup and view all the answers

In photoallergic reactions, which of the following treatments is aimed at controlling inflammation and itching?

Corticosteroids Signup and view all the answers

What preventive measure is emphasized for patients prone to erythema ab igne?

Discontinuing the use of heating pads Signup and view all the answers

What is the typical appearance of skin affected by erythema ab igne?

Localized red, mottled areas Signup and view all the answers

Which of the following statements about the treatment of perniosis is accurate?

Avoidance of cold exposure is essential in treatment. Signup and view all the answers

What are some systemic symptoms that may accompany severe cases of polymorphic light eruption?

Fatigue and malaise. Signup and view all the answers

Describe the type of testing that may be conducted to evaluate UV sensitivity in cases of polymorphic light eruption.

Phototesting may be conducted to assess UV sensitivity. Signup and view all the answers

What is the role of topical corticosteroids in the treatment of polymorphic light eruption?

They are used to reduce inflammation and alleviate symptoms. Signup and view all the answers

Identify a potential environmental trigger that could exacerbate polymorphic light eruption.

Reflective surfaces such as sand or water. Signup and view all the answers

What is the most common form of idiopathic photodermatosis associated with seasonal sun exposure?

Polymorphic Light Eruption. Signup and view all the answers

Study Notes

Reaction to Cold

Exposure to extreme cold can result in skin reactions in anyone.
Persistent sores or growing lumps within a cold-induced rash may require a skin biopsy to rule out skin cancer.
Abnormally pigmented areas of skin due to cold exposure can persist for years.
Treatment options for cold-induced skin pigment changes include topical tretinoin or laser therapy.

Erythema ab igne (EAI)

EAI is a skin condition caused by repeated exposure to heat, typically from sources like heating pads or fireplaces.
It presents as a reddish-brown, reticular pattern on the skin, often resembling a "fire mark".

Miliaria (Sweat Rash)

Miliaria occurs when sweat glands become blocked, leading to trapped sweat.
This blockage can be caused by factors like heat, humidity, and tight clothing.
Miliaria often results in a rash with small, itchy bumps.
Immediate darkening of the skin pigment can occur.

Photoallergic Reaction

Photoallergic reaction is an immune reaction that occurs after exposure to ultraviolet (UV) light.
Unlike a sunburn, it takes several days to develop and involves delayed hypersensitivity.

Phototoxic Reaction

Phototoxic reactions are caused by a direct chemical reaction between a substance and UV light, leading to skin damage.
These reactions often occur quickly, within minutes to hours of UV exposure.

UV Radiation

UVB radiation (290–320 nm) is responsible for:
- Sunburn
- Phototoxic reaction
- Delayed pigment darkening
- Premalignant and malignant skin conditions
UVC radiation (200–290 nm) is more damaging and associated with:
- Actinic keratosis
- Basal cell carcinoma
- Squamous cell carcinoma
- Malignant melanoma

Skin Pigmentation

Immediate pigment darkening is a temporary darkening of the skin following UV exposure.
This pigmentation change typically appears within minutes and lasts for a few hours.

Frost Bite

Frostbite is an abnormal reaction to cold exposure that affects a small, susceptible portion of the population.
Genetic predisposition likely plays a role.
Examples of abnormal cold reactions include chilblains, cryoglobulinemia, and others.

### Chilblains (Perniosis)

An abnormal vascular response to cold exposure, resulting in painful, inflammatory lesions.
Commonly affects older children and young adults.
Occur in the middle of the epidermis.

Miliaria Profunda

Blockage at or below the dermo-epidermal junction following repeated episodes of miliaria rubra.
Asymptomatic, flesh-colored, firm papules (2-3 mm in size).

Treatment for Chilblains

Avoid hot exposure.

Senile Skin Changes

Solar elastosis.
Senile comedones.
Telangiectasia.
Poikiloderma of Civatte.

Premalignant and Malignant Skin Conditions

Primarily caused by UVB radiation.

Phototoxic Reactions

Resemble an exaggerated sunburn or blisters.
Occur in sun-exposed skin.
Not immunologically mediated.
High incidence (affecting all people).
Require large amounts of the agent.
Onset occurs within minutes to hours.
Only a single exposure is needed.

Photoallergic Reactions

Dermatitis-like reaction.
Occur in sun-exposed skin, potentially spreading to unexposed areas.
Immunologically mediated (Type IV hypersensitivity).
Low incidence (predisposed individuals).
Require small amounts of the agent.
Onset takes 24-72 hours.
Multiple exposures are needed.

Photosensitizing Agents

Tetracyclines
Phenothiazines
Amiodarone
Nalidixic acid

Phytophotodermatitis

Photosensitivity responses resulting from contact with plants or their products on sun-exposed areas.

Abnormal Reactions to Sun Exposure (Photodermatoses)

Photodermatoses are abnormal reactions to sun exposure.
Metabolic diseases can cause photodermatoses, including:
- Porphyria
- Xeroderma pigmentosum
- Pellagra
Drug-induced photodermatoses can occur due to both topical and systemic medications.
Diseases aggravated by sunlight include:
- Actinic lichen planus
- Erythema multiforme
- Lupus erythematosus
Idiopathic photodermatoses have unknown causes, and include a variety of conditions:
- Polymorphic light eruption
- Solar urticaria
- Chronic actinic dermatitis
- Hydroa aestivale (summer prurigo of Hutchinson)
- Hydroa vacciniform
- Juvenile spring eruption
- Actinic reticuloid

Perniosis (Chilblains)

Inflammatory response of the skin, triggered by cold exposure
Symptoms include redness, itching, and swelling
Treatment involves avoiding cold exposure
Topical treatments include corticosteroids and capsaicin cream
Oral medications like nifedipine are used for severe cases to improve blood circulation
Moisturizers prevent dry skin

Erythema Ab Igne

Skin condition caused by prolonged exposure to heat
Leads to a red, mottled appearance on the skin
Avoiding heat sources is crucial
Topical corticosteroids are used to reduce inflammation
Retinoids can be applied to improve skin texture
Avoiding future thermal injuries is recommended

Milaria (Heat Rash)

Blocked sweat glands cause sweat retention, leading to the condition
Staying in a cool environment and removing excess clothing are important
Calamine lotion helps soothe irritation, while antihistamines relieve itching
Wearing breathable fabrics and hydration help prevent heat rash

Phototoxic Reactions

Occur after exposure to UV light when using certain medications or substances
Remove the offending agent immediately if possible
Cool compresses and soothing lotions, like aloe vera, can be applied
Corticosteroids help reduce inflammation
Sun protection measures like broad-spectrum sunscreen and protective clothing should be implemented

Photoallergic Reactions

An immune-mediated reaction triggered by UV light after applying photosensitizing agents
Discontinue using the offending agent
Topical corticosteroids control inflammation and itching
Antihistamines provide relief for symptoms
Sun protection strategies, including sunscreen and protective clothing are crucial

Polymorphic Light Eruption

A common type of idiopathic photodermatosis (skin reaction to sunlight with unknown cause).
Characterized by a red, itchy, or burning rash that appears on sun-exposed areas like the face, neck, and arms.
Rash develops hours to days after UV exposure, often during spring and summer.
Lesions can appear as papules, plaques, or vesicles (small bumps, flat raised areas, or fluid-filled blisters).
Symptoms usually resolve spontaneously within days, but lesions may recur with further sun exposure.
The exact cause is unknown, but genetics and an exaggerated immune response to UV radiation are thought to play a role.
Environmental factors, such as altitude, reflective surfaces (sand, water), and certain medications or photosensitizers, can exacerbate the condition.
Treatment involves avoiding sun exposure, using broad-spectrum sunscreen, and using topical corticosteroids to reduce inflammation and itching.
Oral antihistamines can provide relief from itching.
UV phototherapy can be used as a preventative measure in recurrent cases.
Immunosuppressive therapy is a last resort for severe and resistant cases.

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Description

This quiz covers various skin reactions induced by extreme temperatures, including cold-induced rashes, erythema ab igne, and miliaria. Learn about symptoms, treatments, and the effects of prolonged exposure to cold and heat on skin health.