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Photoprotection in Lupus — SCE Dermatology MCQ

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EasyPhotobiologyPhotoprotection in LupusSCE Dermatology

A 40-year-old woman with cutaneous lupus has been on Hydroxychloroquine for 3 years with good response. She now develops a malar rash flare during summer despite treatment. What additional photoprotection measure should be specifically emphasised?

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Correct answer: D — Broad-spectrum SPF 50+ sunscreen with high UVA protection (UVA star rating 4-5) applied liberally 30 minutes before sun exposure and reapplied every 2 hours

For photosensitive conditions like cutaneous lupus erythematosus, rigorous broad-spectrum (UVA + UVB) photoprotection with SPF 50+ sunscreen with high UVA protection is essential. Many patients use inadequate protection — common errors include insufficient UVA coverage, inadequate application amount (2 mg/cm² recommended), failure to reapply, and neglecting photo-exposed areas. UVA penetrates glass and cloud, so year-round protection is needed. Additional measures include UPF 50+ protective clothing, wide-brimmed hats, UV-filtering window film, and behavioural sun avoidance. Photosensitivity in CLE occurs across UVA and UVB wavelengths and visible light. Tinted sunscreens with iron oxide provide additional visible light protection.

Reference: BAD 2016 CLE; BAD 2019 Photoprotection