Sunburn

Presentation

Patients generally seek help only if their sunburn is severe. There will be a history of extended exposure to sunlight or to an artificial source of ultraviolet radiation, such as a sunlamp. Patients at highest risk typically have fair skin, blue eyes, and red or blond hair. The burns will be accompanied by intense pain, and the patient will not be able to tolerate anything touching the skin. Most exposure is limited to sun-exposed areas of the body ( Fig. 181.1 ). There may be systemic complaints of “sun poisoning” that include nausea, vomiting, chills, and fever. The affected areas are erythematous and are accompanied by mild edema. Erythema develops after 2 to 6 hours and peaks at 12 to 24 hours. The more severe the burn, the earlier it will appear and the more likely that it will progress to edema and blistering. Signs and symptoms usually resolve over 4 to 7 days, often with skin scaling and peeling ( Fig. 181.2 ).