Diagnostic Considerations

Regarding rash, consider the following:

Infantile atopic eczema
Seborrheic eczema
Nutritional pellagra (Misdiagnosis can be prevented by performing urine chromatography.)
Congenital poikilodermas with photosensitivity (eg, Cockayne syndrome)
Malar rash of lupus erythematosus
Carcinoid syndrome (may lead to disturbance of tryptophan metabolism and pellagralike rash)
Indicanuria in inborn errors of amino acid metabolism (eg, phenylketonuria, blue diaper syndrome)

For the central nervous system, consider the following:

Ataxia-telangiectasia (can cause diagnostic difficulties, especially in patients with mild skin involvement)
Systemic lupus erythematosus (can be confused if photosensitivity with neuropsychiatric symptoms is present)
Other ataxias with biochemical and genetic defects

Differential Diagnoses

Workup

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Media Gallery

Photosensitivity with erythema, desquamation, and hypopigmentation and hyperpigmentation on the face.
Erythema and desquamation on the sun-exposed area of the right arm.

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Author

Lidija Kandolf Sekulovic, MD, PhD Professor, Head of the Department of Dermatology and Venereology, Medical Faculty, Military Medical Academy, Belgrade, Serbia

Lidija Kandolf Sekulovic, MD, PhD is a member of the following medical societies: American Society of Clinical Oncology, European Academy of Dermatology and Venereology, European Society for Medical Oncology, Serbian Association of Dermatorvenerologists

Disclosure: Nothing to disclose.

Coauthor(s)

Djordjije Karadaglic, MD, DSc Professor, School of Medicine, University of Podgorica, Podgorica, Montenegro

Djordjije Karadaglic, MD, DSc is a member of the following medical societies: American Academy of Dermatology, European Academy of Dermatology and Venereology, Serbian Association of Dermatorvenerologists

Disclosure: Nothing to disclose.

Ljubomir Stojanov, MD, PhD Lecturer in Metabolism and Clinical Genetics, University of Belgrade School of Medicine, Serbia

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Acknowledgements

Mark A Crowe, MD Assistant Clinical Instructor, Department of Medicine, Division of Dermatology, University of Washington School of Medicine

Mark A Crowe, MD is a member of the following medical societies: American Academy of Dermatology and North American Clinical Dermatologic Society

Disclosure: Nothing to disclose.