Polymorphic light eruption Research

Research articles regarding treatment and characteristics of interest to people with PMLE. For more information, visit www.pubmed.com to continue searching.  At pubmed, enter your search criteria. Once you have results, choose the Display option "abstracts". Once you find an article you like, click "Related Articles" to find similar articles.

Clinical, laboratory, phototest and phototherapy findings in polymorphic light eruptions: a retrospective study of 133 patients.  [Mastalier U, Kerl H, Wolf P.]

Eur J Dermatol. 1998 Dec;8(8):554-9. , Mastalier U, Kerl H, Wolf P.
Department of Dermatology, Karl Franzens University, Graz, Auenbruggerplatz 8, A-8036 Graz, Austria.

In the present study, we retrospectively evaluated the clinical, laboratory, phototest and phototherapy findings in 133 patients (109 females and 24 males) with polymorphic light eruption (PLE). The median age of the patients at onset of PLE was 26 years (range, 3-62 years). The median duration of PLE at presentation was 6.5 years (range, 1 week to 25 years). Interestingly, we found two peaks in the distribution curve of the individual latent interval, the time between light exposure and the appearance of skin lesions. The first peak occurred at 1-1.5 hr and the second peak at 24 hrs after light exposure. Six of 33 patients tested had antinuclear antibodies (ANA). However, none of these ANA-positive patients had or developed systemic lupus erythematosus during follow-up. Phototesting revealed that minimal erythema doses for UVA and UVB fell within normal limits in 30 patients tested. Provocative phototesting was positive in 17 of 30 (57%) patients tested. The action spectrum fell within the UVA range in 10 (59%), the UVB range in 4 (23%), and both ranges in 3 (18%) of the 17 cases. Ninety-two patients received preventive phototherapy including broad-band UVB, broad-band UVA, or psoralen and ultraviolet A (PUVA). Follow-up information was available for 79 of these patients: the complete protection rate in the first summer season after therapy was 27% for UVB, 0% for UVA, and 53% for PUVA whereas the overall protection rate (including partial and complete responders) was 83% for UVA, 82% for UVB and 65% for PUVA. In contrast, the patients' histories revealed that the use of a sunscreen with a mean sun protection factor (SPF) of 14 did not prevent skin lesions in 88% of PLE patients.

PMID: 9889427 [PubMed - indexed for MEDLINE] 

Polymorphous light eruption: A clinical, photobiologic, and follow-up study of 110 patients.
Boonstra HE, van Weelden H, Toonstra J, van Vloten WA., J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):199-207.
Department of Dermatology, University Hospital Utrecht, The Netherlands.

BACKGROUND: Polymorphous light eruption is a common chronic idiopathic photodermatosis. The action spectrum and therapy are under debate. OBJECTIVE: The aim of the study was to analyze the clinical aspects of this dermatosis, the photodiagnostic tests, and the results of therapy in an academic center. METHODS: To obtain a reasonable follow-up period, we examined all available data of the patients who underwent diagnostic phototests in the period 1985 through 1991. Our procedure of phototesting included determination of minimal erythema doses, photoprovocation tests, and photopatch tests. The evaluation of the effect of the therapy was based on the patients' experiences, time spent outdoors, and amount of sun exposure. RESULTS: Our collection included data on 35 men and 75 women. The age at onset differed significantly between men and women (averages 46 and 28 years, respectively; P <.01). The minimal erythema doses for UVB were lowered in 43% of the men and in 4% of the women (P <.01); the minimal erythema doses for UVA were lowered in 37% of the men and in 11% of the women (P <.01). The photoprovocation tests showed a pathologic reaction to both UVB and UVA in 88% of the men and in 52% of the women (P <.01). In the remaining patients we found pathologic reactions to UVB alone (for men 9%, for women 24%; P >.05) or UVA alone (for men 3%, for women 24%; P <.01). The abnormal reactions to visible light were almost exclusively observed in those patients who reacted pathologically to both UVB and UVA (43% of the male patients, 11% of the female patients; P <.01). The photopatch tests showed a large number of positive test results, mainly to skin care products or sunscreens (75% of all patients). The 70 most sensitive patients (64%) were treated with prophylactic UVB therapy 2 or 3 times a week at home or initially in the outpatient department. This treatment was normally done from February to June, but in severe cases throughout the whole year. CONCLUSION: Phototests revealed abnormal reactions to UVB as well as UVA and to some extent also to visible light. Prophylactic UVB therapy is a successful treatment for polymorphous light eruption.

PMID: 10642673 PubMed

Polymorphous light eruption: action spectrum and photoprotection.
Ortel B, Tanew A, Wolff K, Honigsmann H., J Am Acad Dermatol. 1986 May;14(5 Pt 1):748-53.

Polymorphous light eruption is a common seasonal photodermatosis with a typical history and clinical picture. In the interval, when no lesions are present, the diagnosis relies on artificial reproduction of polymorphous light eruption by phototesting. Photochemotherapy (psoralens with ultraviolet A [PUVA]) is currently an effective preventive treatment. One hundred sixty-seven patients with either a history of polymorphous light eruption or manifest disease entered our study. Of 142 patients tested, 49% developed typical lesions of polymorphous light eruption at the test sites. In 56% the action spectrum was found to be in the ultraviolet A range, in 17% in the ultraviolet B range, and in 26% in both ranges. A total of 122 patients received preventive treatment with PUVA. Of these, fifty-one returned for follow-up. Of the patients who were followed up, 64% reported total protection during outdoor activities in the summer, 26% reported partial protection, and 10% were not protected. Failure to improve was unrelated to the action spectrum. The action spectrum and the incidence of positive results on phototests in our patient population differed from those reported by others. It is possible that differences in the test protocols and in the light sources used may account for this discrepancy. There is clearly a need for a standardized test procedure. However, the majority of patients benefit from PUVA pretreatment regardless of their action spectrum.

PMID: 3711378  PubMed

Management of polymorphous light eruption : clinical course, pathogenesis, diagnosis and intervention.

Fesq H, Ring J, Abeck D.,Am J Clin Dermatol. 2003;4(6):399-406.
Department of Dermatology and Allergy, Technical University Munich, Munich, Germany. heike.fesq@lrz.tu-muenchen.de

Optimal management of patients with polymorphous light eruption (PLE), the most frequent photodermatosis, requires knowledge of the individual clinical course of the disease and pathogenic factors. As PLE often causes problems during leisure-time activities and holidays, resulting in a substantial loss of quality of life, prophylaxis is the most important therapeutic approach. Management of PLE must, therefore, focus on basic preventative measures and additional therapeutic approaches, depending on the clinical condition. PLE can be classified into four severity groups (mild, moderate-to-severe, severe and therapy-resistant), which are useful for determining appropriate prophylactic measurements. No specific laboratory tests are available for the diagnosis of PLE, therefore, a clinician must rely on the clinical appearance of the disorder (e.g. clinical symptoms, the location of the lesions, the relationship of the occurrence of the lesions with sun exposure and the time course of the lesions) as well as a patient's medical history in order to make a diagnosis.Basic preventative management of PLE consists of adequate sun protection comprising avoidance of sun exposure, the use of textile sun protection and the application of broadband sunscreens with high UVA protection potential. Other supportive measurements have to be managed individually and are dependent on the patient's medical history and the severity of the disease. Topical antioxidants, systemic immunomodulation, photo(chemo)therapy and systemic immunosuppression may be required in some cases of PLE. Topical antioxidants represent a new treatment approach for moderate-to-severe PLE and are an effective and well tolerated option for this patient population. Severe PLE also requires photo(chemo)therapy. Phototherapy can be in the form of 311 nm UVB or UVA1 irradiation. In cases where 311 nm UVB or UVA1 are ineffective, psoralen plus UVA (PUVA) bath therapy may be used. However, PUVA bath therapy must be used with caution because it is associated with acute and long-term adverse effects. In rare exceptions we would consider using oral PUVA therapy. However, in our outpatient department, quality of life of most patients is improved with the treatment regimens that are recommended for patients with moderate-to-severe PLE, without the need for photo(chemo)therapy.

PMID: 12762832 PubMed

Juvenile spring eruption of the ears: a probable variant of polymorphic light eruption.

Berth-Jones J, Norris PG, Graham-Brown RA, Burns DA, Hutchinson PE, Adams J, Hawk JL., Br J Dermatol. 1991 Apr;124(4):375-8.

Department of Dermatology, Leicester Royal Infirmary, U.K.

We report 18 cases in which a pruritic, erythematous, papular and vesicular eruption developed on the ears following sun exposure. Four of these patients had, on other occasions, suffered from typical polymorphic light eruption. The clinical features, histological changes, and results of phototesting suggest that juvenile spring eruption of the ears is a localized form of polymorphic light eruption.

PMID: 2025559