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Ultraviolet light burn: a cutaneous complication of visible light phototherapy of neonatal jaundice
E C Siegfried1, M S Stone, K C Madison
1Department of Dermatology, University of Iowa, Iowa City 52242.
Insights
Visible light phototherapy effectively treats neonatal jaundice but can cause skin burns from ultraviolet A (UVA) exposure without protective shields. Premature infants are particularly vulnerable, necessitating vigilant use of Plexiglass shields during treatment.
Area of Science:
- Neonatal Medicine
- Dermatology
- Phototherapy
Background:
- Visible light phototherapy is a standard treatment for neonatal indirect hyperbilirubinemia.
- Cutaneous side effects are known, including rashes and bronze baby syndrome.
- Ultraviolet (UV) radiation exposure is a potential hazard.
Observation:
- Two premature infants developed erythema, one with a second-degree burn.
- This occurred due to prolonged ultraviolet A (UVA) exposure from fluorescent daylight bulbs used without Plexiglass shields.
- Premature infants are highly susceptible to UVA-induced erythema, especially within the first two weeks of life.
Findings:
- Inadvertent use of fluorescent daylight bulbs without Plexiglass shields can lead to hazardous UVA exposure.
- This exposure can cause severe skin reactions, including burns, in premature infants.
- Plexiglass shields are crucial for preventing UVA-induced erythema during phototherapy.
Implications:
- Nursery staff must be educated on the critical importance of using Plexiglass shields during phototherapy.
- Standard protocols should emphasize the consistent use of protective shields to prevent phototherapy-induced burns.
- Ensuring shield placement is vital for infant safety during jaundice treatment.
Abstract:
Visible light phototherapy is an easily administered and effective treatment for neonatal indirect hyperbilirubinemia. Reported cutaneous side effects include transient rashes and the uncommon bronze baby syndrome. A more hazardous side effect is ultraviolet burn. Two premature infants developed phototherapy-induced erythema, one associated with a second-degree burn, after exposure to fluorescent daylight bulbs inadvertently used without Plexiglass shields, thus allowing prolonged ultraviolet A (UVA) exposure. Premature infants, especially during the first two weeks of life, may be significantly susceptible to UVA-induced erythema. Plexiglass shields should always be in place during visible light phototherapy, and nursery staff should be made aware of their purpose.