Version May 2024
| Sex | Age of onset | Timeline of eruption | Location | Common lesion morphology and symptoms | Family history | Action spectrum | Phototesting | Laboratory findings | Duration/ resolution | Key features | |
| Polymorphous light eruption | F>M | First 3 decades | Hours after sun exposure, lasts days to weeks; most conspicuous in spring; improves during summer | Sun-exposed areas | Pruritic papules, papulovesicles, plaques. | May be present | UVA, UVB, visible | Normal MED; provocative phototesting may induce lesions | Recurrent over the course of years, may improve over time | Most common photodermatosis; "hardening" phenomenon may occur | |
| Juvenile spring eruption | M>F | Primarily childhood; also may be seen in young adults | As with polymorphous light eruption | Classically, helices of ears | Erythematous papules, bullae. | May be present | UVA? | As with polymorphous light eruption | Recurrent over years, may improve with age | ||
| Actinic prurigo | F>M, M>F reported in adult onset in Asia | Childhood; adult onset may occur in Asians | Persistent during summer; may also be present year round | Sun-exposed areas, may also affect unexposed areas | Pruritic papulonodules, crusts, excoriations, lichenification, cheilitis. | Yes, in up to 50% | UVA>UVB | 60% with reduced MED, 60 to 70% with positive provocative phototests | Improves in adolescence, but also may persist | More common in American Indians and Mestizos. May have ocular findings. | |
| Hydroa vacciniforme | Slight M>F | Childhood | Hours after sun exposure | Face, dorsal hands | Erythematous macules, papules, vesicles, crusts. | Rarely positive | Likely UVA | May show reduced MED to UVA in some cases | Usually resolves by adolescence/young adulthood, but may persist | Lymphoproliferative disease association with severe cases | |
| Chronic actinic dermatitis | M>F | Older, but may be seen in younger patients | Persistent; worsens in summer, may have findings year round | Sun-exposed areas | Eczematous patches, lichenification, may see palmoplantar involvement. | UVA, UVB, visible light | Decreased MEDs to UVA, UVB, or visible light | May see Sézary cells in severe cases | Persists for years, may resolve | Often coexistent contact dermatitis | |
| Solar urticaria | F>M | Young or mid-adulthood | Appears within minutes, individual lesions resolve within 24 hours | Sun-exposed areas | Urticarial plaques (hives), occasional systemic symptoms. | UVA, UVB, visible light | Evaluated with MUD | Persists for years, may resolve | "Hardening" phenomenon may occur | ||
| Phototoxicity | M = F | Any age | Appears within hours of sun exposure, can occur after first dose of drug | Sun-exposed areas | Exacerbated sunburn appearance. | UVA | In systemic phototoxicity, MED for UVA decreased, UVB and visible light MEDs normal | Resolves when drug discontinued and cleared from body | Can occur in anyone | ||
| Photoallergy | M = F | Any age | Appears 1 to 2 days after exposure to sun and inciting agent in sensitized individual | Sun-exposed areas | Pruritic, eczematous lesions. | UVA | In systemic photoallergy, MED for UVA decreased, UVB and visible light MEDs normal. Occasional drugs have reduced MED to UVB rather than UVA. | Resolves with discontinuation of inciting agent | Usually due to topical agents | ||
| Erythropoietic protoporphyria | M = F, versus slight M>F | Onset in early childhood | Symptoms begin within minutes of sun exposure, improves in winter | Nose, cheeks, hands | Burning and stinging, pain, pruritus. Erythema, edema, purpura. Heals with atrophic, wax-like scars; wrinkled knuckles. | Common (siblings), autosomal recessive or pseudodominant | Soret band (400 to 410 nm) | Often normal, some patients may note stinging sensation or lesions | Elevated erythrocyte protoporphyrin level | Chronic | May develop liver disease |
| Porphyria cutanea tarda | M = F | Middle age, may occur earlier | Sun-exposed areas | Skin fragility, bullae, crusts, scarring. Hypertrichosis, hyperpigmentation, sclerodermoid changes. | Sporadic in type I, autosomal dominant in type II | Soret band (400 to 410 nm) | Elevated porphyrins in urine and stool | Chronic, symptoms improve with sun protection, removal of triggers, phlebotomy, antimalarials | Often associated with hepatitis C | ||
| Pseudoporphyria | F>M | Any age; 10% of children taking naproxen | Sun-exposed areas | Skin fragility, bullae, crusts, scarring, milia. | Negative | UVA | Normal porphyrin levels | Symptoms resolve with sun protection, avoidance of tanning bed use, and discontinuation of the causative medications | May be caused by medications, renal failure and hemodialysis, and excessive tanning bed use |
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