The histopathologic picture is characteristic and shows a perivascular lymphocytic. All were advised to use topical clobetasol propionate 0. Although doctors have researched polymorphous light eruption fairly extensively, the condition appears to be idiopathic in. The results obtained in 106 ple patients 85 uva, 21 uvb. The role of histopathology in polymorphous light eruption. In polymorphic light eruption, sections show a superficial and deep perivascular lymphocytic infiltrate figure 1. Polymorphous light eruption symptoms, diagnosis and. Ple symptoms develop after uv exposure behind glass where only longer uva wavelengths can penetrate, dummer r, ivanova k, scheidegger ep, et al. We suggest papulovesicular light eruption as a suitable name for this common and distinctive subset of pmle. In the year 1798 robert willian described an erythemato vesicular eruption on sun exposed areas in the summer season due to the irritation of direct sunlight and named it as eczema solare. The condition may occur in children, but typically manifests in adults. Your doctor may suggest phototherapy to prevent seasonal.
Selfcare measures, like using a nonprescription anti. Illuminating the relation between polymorphous light. Onset of lesions 18 24 hours after light exposure, usually in spring summer associated with thyroid disease or lupus in some patients juvenile spring eruption appears to be either a form of polymorphous light eruption or a closely related disorder use photo testing to establish diagnosis. The progress of the clinical improvement began to slow after 1 to 3 weeks of the. Pmle is characterized by recurrent, abnormal, delayed reactions to sunlight, ranging from erythematous papules, papulovesicles, and plaques to erythema multiforme like lesions on sunlightexposed surfaces. This is the first description of po lymorphous light eruption pmle. Polymorphous light eruption an overview sciencedirect. Repeat episodes are less likely as the summer progresses. Aprof amanda oakley, dermatologist, hamilton, new zealand, 1997. It is more common in women then men, affecting 15% of women in the uk. Feb 28, 2020 polymorphous light eruption occurs most often during spring and early summer when a persons exposure to sunlight increases. Polymorphous light eruption medical condition youtube.
Polymorphous light eruption usually goes away on its own without scarring within 10 days. Clinicopathologic study of solar dermatitis, a pinpoint papular variant. Patients with this condition develop papules, papulovesicles, or erythematous plaques in response to sun exposure. Polymorphous light eruption ple is considered a disease only of the skin. Natural cure for polymorphous light eruption and alternative. The lesions erupt a few hours to several days after.
Juvenile spring eruption is a variant of ple, affecting only the ears. This new dermoscopic finding in polymorphous light eruption helps to delineate it from similar clinical presentations. The rash subsides sponta neously within several days without leaving scars. It occurs after solar or artificial uvlight exposure and affects only the sunexposed areas with preference of the varea of the chest, of arms. Limit time spent in the sunlight, use sunscreen and wear protective clothing.
Polymorphous light eruption symptoms and causes mayo clinic. Polymorphic light eruption pmle is a form of photosensitivity, which usually occurs in younger females. This designation was widely accepted to characterize urticarial, papular, vesicular, and ecze matous reactions precipitated by light 4. Polymorphous light eruption journal of dermatological science. Treatment of polymorphous light eruption usually isnt necessary because the rash typically goes away on its own within 10 days. Actinic prurigo, polymorphous light eruption limited concept, polymorphous light eruption expansive concept, american indian, status indian, metis search for similar articles you may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search. Both also show vacuolar degeneration of the basal layer. Soeprono teaches and practices dermatopathology at loma linda university, school of medicine, department of dermatology. It occurs after solar or artificial uv light exposure and affects only the sunexposed areas with preference of the varea of the chest, of arms and forearms, legs, upper part of the back, and rarely the face. Mar 25, 2020 the mechanics of polymorphous light eruption are not fully understood, but doctors suspect that it is an acquired reaction to ultraviolet light. The effect of topical indomethacin on the intensity of uvb and uvainduced erythema was measured by reflectance spectrophotometry in 23 patients with polymorphic light eruption.
Other clinical variants of pmle were not seen in our patients, however, which suggests that this condition is more monomorphous than polymorphous. Polymorphous light eruption an overview sciencedirect topics. Illuminating the relation between polymorphous light eruption. It is an idiopathic acquired disorder in which a delayed cutaneous response to ultraviolet radiation occurs in the form of skin eruptions consisting of papules, vesicles or plaques over the sunexposed. Polymorphous light eruption definition of polymorphous. Illuminating the relation between polymorphous light eruption and lupus craig a. Due to its many clinical appearances, it is named polymorphic or. Polymorphous light eruption ple is the most common photodermatosis, affecting about 20% of the scandinavian population. Clinical signs include severe itching and small papules, plaques, and papulovesicles on predilection sites, such as the vneck area, dorsal aspects of the arms and hands, legs, and less commonly on the face.
Polymorphous light eruption ple, sometimes also called polymorphic light eruption pmle, is a nonlifethreatening and potentially distressing skin condition that is triggered by sunlight and artificial uv exposure in a genetically susceptible person, particularly in temperate climates during the spring and early summer. Polymorphous light eruption pmle is the most common childhood photodermatosis, accounting for over 75% of photoinduced rashes. A variety of sunlightevoked eruptions, such as solar urticaria. By contrast, the infiltrates in infections by borrelia, polymorphous light eruption, pernio, and tumid lupus erythematosus usually affect the entire dermis. Polymorphous light eruption ple is a benign skin disease that occurs in genetically predisposed people after intensive uv exposure. Small grouped papules on the nose and adjoining skin with a lichenoid histopathology appear to represent a distinct clinicopathological entity. Treatment of polymorphous light eruption springerlink. B with a single exposure to i minimal erythema dose med, a single exposure. Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a virtual dermatopathology reference and guide.
Polymorphous light eruption pmle is an acquired disease and is the most common of the idiopathic photodermatoses. Dermatopathology colloquium, may 2325, 1986, graz, austria. Characteristics of diagnosed polymorphous light eruption. Polymorphous light eruption ple has particular features in latin america. Lupus erythematosus and polymorphous light eruptions core. A skin rash from sunlight that appears hours or within a day or two of light exposure, and that clears after a few days to a week or two, is a common sign.
Several people who are sensitive to sunlight can experience a reaction after an episode of intense sun exposure, usually in the spring or early summer. Nov 18, 2014 polymorphous light eruption pmle is a common acquired disease entity belonging to the idiopathic photodermatoses that is uncommonly considered in the hispanic population. It starts during the second and third decades of life. A clinical, photobiologic, and followup study of 110 patients. Treatment is also available to help prevent a rash. Histopathology lymphocytic vasculitis of artery in deep dermissubcutis intimal thickening fibrinoid ring in the lumen. In the 300 consecutive cases diagnosed clinically as a drug eruption, we encountered only two with a superficial and deep wholly lymphocytic infiltrate. Our goal was to describe the characteristics of pmle diagnosed in a general clinic setting. Polymorphous light eruption is the most common photodermatosis, with a prevalence of as high as 1020% in western europe and in the usa.
Summary provocative light testing was performed in ten patients with polymorphous light eruption pmle and in ten normal subjects to determine whether the. Polymorphic light eruption is a fairly common skin rash triggered by exposure to sunlight or artificial ultraviolet uv light. Diagnosis is clinical and histopathological features vary according to age of. Polymorphous light eruption, also known as polymorphic light eruption, is a rash caused by sun exposure in people who have developed sensitivity to sunlight. What is polymorphic light eruption polymorphic light eruption, also known as polymorphous light eruption, pmle, and prurigo aestivalis, is a common form of primary photosensitivity that mainly occurs in young adult women in temperate climates during spring and summer. Histopathology of drug eruptions general criteria, common. May 02, 2008 illuminating the relation between polymorphous light eruption and lupus craig a. Polymorphic light eruption, also known as polymorphous light eruption, pmle, and prurigo aestivalis, is a common form of primary photosensitivity that mainly occurs in young adult women in temperate climates during spring and summer. Photodermatoses are skin diseases which are caused by exposure to sunlight.
An itchy or burning rash appears within hours, or up to 2 to 3 days after exposure to sunlight. Polymorphic light eruption manifests as itchy, red or skincolored, nonscarring papules, vesicles, plaque and nodules that erupts symmetrically on sun exposed areas within few hours of sun exposure. To lower the reaction and prevent future episodes, practice sun protection measures. Polymorphous light eruption disease reference guide. In pmle, crops of red macules, papules, vesicles, or plaques typically erupt on exposed areas several hours to several days after intensive sun exposure in the early spring. This disease predominates in places at high altitudes and is very rare at. Polymorphous light eruption pmle is the most common idiopathic photodermatosis. Pppmle, micropapular light eruption in japanese, summertime actinic lichenoid. Polymorphic light eruption ple is the most common of the photodermatoses. Polymorphous light eruption pmle is a photodistributed reaction to ultraviolet light uva and sometimes uvb, characterized by a pruritic polymorphous eruption, including erythematous papules, eczematous papulosquamous lesions, and vesicles. Clinical and therapeutic aspects of polymorphous light eruption.
Lichenoid pseudovesicular papular eruption on nose. Histopathologic examination n 10 revealed a mild spongiotic dermatitis. Dermatopathology reference describes polymorphous light eruptions histopathology including histologic features and provides links to additional medical references. Is polymorphous light eruption associated with other diseases. A followup study from finland of 94 patients with ple evaluated the natural history of this disease and possible associations with autoimmune disease, including lupus erythematosus. It may be related to actinic lichen nitidusmicropapular variant of polymorphous light eruption.
Provocative light testing was performed in ten patients with polymorphous light eruption pmle and in ten normal subjects to determine whether the histopathology of irradiated test sites could be used as an end point for a positive response. This study was designed in order to prove on a largescale basis the efficacy of oral photochemotherapy puva in the prevention of polymorphous light eruption ple, to work out indication criteria for puva treatment of this disease, and to establish a simple method based on anamnestic data to differentiate uva from uvb induced ple. In black individuals pinpoint papules are most common presentation. Pmle usually presents as a pruritic rash in sunexposed areas hours to days after sun exposure and persists for several days before subsiding 1. It is more common in patients who receive only intermittent sun exposure and typically consists of crops of papules, vesicles or plaques. The characteristics of polymorphous light eruption pmle have been described in patients evaluated and diagnosed at specialized photodermatology centers. Polymorphic refers to the fact that the rash can take many forms, although in one individual it usually looks the same. Polymorphous light eruption ple, an idiopathic photodermatosis, was first described by robert willan in 1798 stratigos et al, 2002, who called it eczema solare. In pmle, crops of red macules, papules, vesicles, or plaques typically erupt on exposed areas several hours to several days after intensive sun exposure in the early spring fig. The rash usually appears as red, tiny bumps or slightly raised patches of skin. Polymorphous light eruption pmle is a common acquired disease entity belonging to the idiopathic photodermatoses. It lasts for up to 2 weeks, healing without scarring. Juvenile spring eruption appears to be either a form of polymorphous light eruption or a closely related disorder use photo testing to establish diagnosis clinical images. In contrast, the chronic lichenified ap lesions are associated with marked hyperkeratosis, acanthosis, elongation of the rete ridges, and tissue repair.
Jan 31, 2011 in the 300 consecutive cases diagnosed clinically as a drug eruption, we encountered only two with a superficial and deep wholly lymphocytic infiltrate. If your symptoms are severe, your doctor may prescribe antiitch medicine a corticosteroid cream or pill. Disease associations in polymorphous light eruption. A clinicoepidemiological and histopathological study of. Polymorphous light eruption diagnosis and treatment mayo. Polymorphous light eruption diagnosis and treatment. Microscopic analysis of skin tissue is mostly not necessary, but. Polymorphous light eruption pmle or ple is the most common form of photodermatosis. Br j dermatol 2008 may contrary to expectations, no patients with pmle progressed to cutaneous lupus during a relatively long followup period. It has been theorized that the condition is caused by compounds in the skin which change in reaction to uv exposure, triggering an immune system response which in turn creates the rash. By contrast, the infiltrates in infections by borrelia, polymorphous light eruption, pernio, and tumid lupus erythematosus usually affect the. It is more common in patients who receive only intermittent sun exposure and typically consists of crops of papules, vesicles or plaques histology of polymorphic light eruption.
Polymorphous light eruption treatment usually isnt necessary because the rash typically resolves on its own in seven to 10 days. Polymorphous light eruption is a common rash that occurs as a result of sensitivity to sunlight photosensitivity. Polymorphous light eruption ple is the commonest immunomediated photodermatosis. A clinicopathological study of poly morphous light eruption. Polymorphous light eruption can often be diagnoses by a doctor from a description of the symptoms, the length of the rash, and the history of the individual. But the rash often recurs each year after the first incident. The role of histopathology in polymorphous light eruption light testing. Summary provocative light testing was performed in ten patients with polymorphous light eruption pmle and in ten normal subjects to determine whether the histopathology of irradiated test sites could be used as an end point for a positive response.
Both polymorphous light eruptions and lupus erythemato sus may. Polymorphous light eruption pmle, also termed polymorphic light eruption, is the most common photodermatosis encountered in clinical practice. Polymorphous light eruption history and exam bmj best. The fact that uva wavelengths play a prominent role in the elicitation of ple symptoms is further supported by the following findings. Polymorphous light eruption, or polymorphic light eruption, is a skin condition caused by sunlight this video contains general medical information. Since then several names have been used to describe. Polymorphous light eruption occurs most often during spring and early summer when a persons exposure to. All patients in these series showed a rapid reduction in their symptoms and decreased ulcer size after the first treatment session.
The first category is probably immunologic and includes polymorphous or polymorphic light eruption pmle, actinic prurigo, hydroa. More cases need to be examined dermoscopically to further establish ring scales as diagnostic for polymorphous light eruption. Unraveling the pathogenesis of polymorphous light eruption. Both show spongiosis, superficial and sometimes deep perivascular lymphocytic infiltrates, and papillary dermal edema. Jan 22, 2020 polymorphous light eruption pmle is an acquired disease and is the most common of the idiopathic photodermatoses.