Burning Discomfort and Swelling of the Hands and Face of a Young Child

Abstract

<h3>REPORT OF A CASE</h3> A healthy 4-year-old white boy presented with a 2.5-year history of recurrent stinging and burning discomfort of the dorsum of the hands, cheeks, nose, and chin following brief sun exposures. Within hours after sun exposure, his hands and face became painful and swollen. Edema gradually subsided over several days. Episodes typically occurred in late spring, summer, or early fall. At 16 months, the infant was noted to cry inconsolably on going outdoors. At age 3 years, the child resisted playing outdoors and preferred playing indoors near the air conditioner during the summer months. Despite his apparent cutaneous discomfort, he was never noted to have sunburns, blisters, hives, or "rashes." Family history was remarkable for a maternal uncle with similar photosensitivity and mild scarring of the face and dorsum of the hands. No personal or family history of urine or tooth discoloration was noted. Physical findings were