eMedicine Specialties > Dermatology > Photo-Related Diseases

Polymorphous Light Eruption: Follow-up

Author: Noah S Scheinfeld, MD, JD, FAAD, Assistant Clinical Professor, Department of Dermatology, Columbia University; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Private Practice
Coauthor(s): Sophie Shirin, MD, Consulting Staff, Global Dermatology; Raul Del Rosario, MD, Consulting Staff, Surgical Pathology and Dermatopathology, South Coast Medical
Contributor Information and Disclosures

Updated: Oct 23, 2009

Follow-up

Deterrence/Prevention

  • Avoiding sunlight during the hours of most intense UV irradiation (from 10 am to 2 pm) and wearing protective clothing (eg, hats, gloves, long sleeves) should be emphasized to polymorphous light eruption (PMLE) patients.
    • Blue denim clothing is particularly beneficial in terms of sun protection.
    • Wide range sunblocks with a high SPF should be applied and reapplied during the day.

Prognosis

  • Some polymorphous light eruption (PMLE) patients experience a less severe reaction with each consecutive year, but many patients have reactions that may worsen with time without appropriate treatment.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Dr. Ada Winkielman, to the development and writing of this article.



More on Polymorphous Light Eruption

Overview: Polymorphous Light Eruption
Differential Diagnoses & Workup: Polymorphous Light Eruption
Treatment & Medication: Polymorphous Light Eruption
Follow-up: Polymorphous Light Eruption
Multimedia: Polymorphous Light Eruption
References

References

  1. Richards HL, Ling TC, Evangelou G, et al. Psychologic distress in polymorphous light eruption and its relationship to patients' beliefs about their condition. J Am Acad Dermatol. Mar 2007;56(3):426-31. [Medline].

  2. Norris PG, Barker JN, Allen MH, et al. Adhesion molecule expression in polymorphic light eruption. J Invest Dermatol. Oct 1992;99(4):504-8. [Medline].

  3. Stephansson E, Ros AM. Expression of intercellular adhesion molecule-1 (ICAM-1) and OKM5 in UVA- and UVB-induced lesions in patients with lupus erythematosus and polymorphous light eruption. Arch Dermatol Res. 1993;285(6):328-33. [Medline].

  4. Aubin F. Why is polymorphous light eruption so common in young women?. Arch Dermatol Res. Oct 2004;296(5):240-1. [Medline].

  5. Schornagel IJ, Sigurdsson V, Nijhuis EH, Bruijnzeel-Koomen CA, Knol EF. Decreased neutrophil skin infiltration after UVB exposure in patients with polymorphous light eruption. J Invest Dermatol. Jul 2004;123(1):202-6. [Medline].

  6. Kolgen W, van Meurs M, Jongsma M, et al. Differential expression of cytokines in UV-B-exposed skin of patients with polymorphous light eruption: correlation with Langerhans cell migration and immunosuppression. Arch Dermatol. Mar 2004;140(3):295-302. [Medline].

  7. Wackernagel A, Back B, Quehenberger F, Cerroni L, Kerl H, Wolf P. Langerhans cell resistance, CD11b+ cell influx, and cytokine mRNA expression in skin after UV exposure in patients with polymorphous light eruption as compared with healthy control subjects. J Invest Dermatol. May 2004;122(5):1342-4. [Medline].

  8. Kerr HA, Lim HW. Photodermatoses in African Americans: a retrospective analysis of 135 patients over a 7-year period. J Am Acad Dermatol. Oct 2007;57(4):638-43. [Medline].

  9. Benanni B, Bruckner T, Bock M, et al. Low incidence of polymorphous light eruption in renal transplant recipients. Acta Derm Venereol. 2007;87(4):372-4. [Medline].

  10. Hönigsmann H. Polymorphous light eruption. Photodermatol Photoimmunol Photomed. Jun 2008;24(3):155-61. [Medline].

  11. Deng D, Hang Y, Chen H, Li H. Prevalence of photodermatosis in four regions at different altitudes in Yunnan province, China. J Dermatol. Aug 2006;33(8):537-40. [Medline].

  12. Draelos ZK, Hansen RC. Polymorphic light eruption in pediatric patients with American Indian ancestry. Pediatr Dermatol. Nov 1986;3(5):384-9. [Medline].

  13. Naleway AL, Greenlee RT, Melski JW. Characteristics of diagnosed polymorphous light eruption. Photodermatol Photoimmunol Photomed. Aug 2006;22(4):205-7. [Medline].

  14. Lugovic Mihic L, Bulat V, Situm M, Cavka V, Krolo I. Allergic hypersensitivity skin reactions following sun exposure. Coll Antropol. Oct 2008;32 Suppl 2:153-7. [Medline].

  15. Jansen CT. The natural history of polymorphous light eruptions. Arch Dermatol. Feb 1979;115(2):165-9. [Medline].

  16. Kontos AP, Cusack CA, Chaffins M, Lim HW. Polymorphous light eruption in African Americans: pinpoint papular variant. Photodermatol Photoimmunol Photomed. Dec 2002;18(6):303-6. [Medline].

  17. Popovic K, Nyberg F, Wahren-Herlenius M, Nyberg F. A serology-based approach combined with clinical examination of 125 Ro/SSA-positive patients to define incidence and prevalence of subacute cutaneous lupus erythematosus. Arthritis Rheum. Jan 2007;56(1):255-64. [Medline].

  18. Schornagel IJ, Guikers KL, Van Weelden H, Brijnzeel-Koomen CA, Sigurdsson V. The polymorphous light eruption-severity assessment score does not reliably predict the results of phototesting. J Eur Acad Dermatol Venereol. Jun 2008;22(6):675-80. [Medline].

  19. Leroy D, Dompmartin A, Verneuil L, Michel M, Faguer K. [Polychromatic phototest sensibility is superior to UVA phototest in polymorphic light eruptions]. Ann Dermatol Venereol. Jun-Jul 2002;129(6-7):860-4. [Medline].

  20. Hadshiew IM, Treder-Conrad C, v Bülow R, et al. Polymorphous light eruption (PLE) and a new potent antioxidant and UVA-protective formulation as prophylaxis. Photodermatol Photoimmunol Photomed. Aug 2004;20(4):200-4. [Medline].

  21. Jeanmougin M, Peyron JL, Thomas P, Beani JC, Guez E, Bachot N. [Polymorphic light eruption: prophylaxis using a topical combination of antioxidants and UVA protection formulations]. Ann Dermatol Venereol. May 2006;133(5 Pt 1):425-8. [Medline].

  22. DeLeo VA, Clark S, Fowler J, Poncet M, Loesche C, Soto P. A new ecamsule-containing SPF 40 sunscreen cream for the prevention of polymorphous light eruption: a double-blind, randomized, controlled study in maximized outdoor conditions. Cutis. Feb 2009;83(2):95-103. [Medline].

  23. Fourtanier A, Moyal D, Seite S. Sunscreens containing the broad-spectrum UVA absorber, Mexoryl SX, prevent the cutaneous detrimental effects of UV exposure: a review of clinical study results. Photodermatol Photoimmunol Photomed. Aug 2008;24(4):164-74. [Medline].

  24. Murphy GM, Logan RA, Lovell CR, Morris RW, Hawk JL, Magnus IA. Prophylactic PUVA and UVB therapy in polymorphic light eruption--a controlled trial. Br J Dermatol. Apr 1987;116(4):531-8. [Medline].

  25. Bilsland D, George SA, Gibbs NK, Aitchison T, Johnson BE, Ferguson J. A comparison of narrow band phototherapy (TL-01) and photochemotherapy (PUVA) in the management of polymorphic light eruption. Br J Dermatol. Dec 1993;129(6):708-12. [Medline].

  26. Barolet D, Boucher A. LED photoprevention: reduced MED response following multiple LED exposures. Lasers Surg Med. Feb 2008;40(2):106-12. [Medline].

  27. Jansen CT. Oral carotenoid treatment in polymorphous light eruption: a cross-over comparison with oxychloroquine and placebo. Photodermatol. Jun 1985;2(3):166-9. [Medline].

  28. Neumann R, Rappold E, Pohl-Markl H. Treatment of polymorphous light eruption with nicotinamide: a pilot study. Br J Dermatol. Jul 1986;115(1):77-80. [Medline].

  29. Ahmed RS, Suke SG, Seth V, Jain A, Bhattacharya SN, Banerjee BD. Impact of oral vitamin E supplementation on oxidative stress & lipid peroxidation in patients with polymorphous light eruption. Indian J Med Res. Jun 2006;123(6):781-7. [Medline].

  30. Norris PG, Hawk JL. Successful treatment of severe polymorphous light eruption with azathioprine. Arch Dermatol. Oct 1989;125(10):1377-9. [Medline].

  31. Boonstra HE, van Weelden H, Toonstra J, van Vloten WA. Polymorphous light eruption: A clinical, photobiologic, and follow-up study of 110 patients. J Am Acad Dermatol. Feb 2000;42(2 Pt 1):199-207. [Medline].

  32. Calzavara Pinton PG, Venturini M, Capezzera R, Zane C, Facchetti F. Photosensitive erythema multiforme and erythema multiforme-like polymorphous light eruption. Photodermatol Photoimmunol Photomed. Jun 2003;19(3):157-9. [Medline].

  33. Dummer R, Ivanova K, Scheidegger EP, Burg G. Clinical and therapeutic aspects of polymorphous light eruption. Dermatology. 2003;207(1):93-5. [Medline].

  34. Epstein JH. Polymorphous light eruption. J Am Acad Dermatol. Oct 1980;3(4):329-43. [Medline].

  35. Epstein JH. Polymorphous light eruption. Photodermatol Photoimmunol Photomed. Jun 1997;13(3):89-90. [Medline].

  36. Fesq H, Ring J, Abeck D. Management of polymorphous light eruption : clinical course, pathogenesis, diagnosis and intervention. Am J Clin Dermatol. 2003;4(6):399-406. [Medline].

  37. Jansen CT. The morphologic features of polymorphous light eruptions. Cutis. Aug 1980;26(2):164-7, 169-70. [Medline].

  38. McFadden N, Larsen TE. Polymorphous light eruption: the properties of a UVA-induced PLME patient group. Photodermatol. Feb 1986;3(1):36-40. [Medline].

  39. Muhlbauer JE, Mihm MC Jr, Harrist TJ. Papular polymorphous light eruption. Fibrin, complement, and immunoglobulin deposition. Arch Dermatol. Jul 1984;120(7):866-8. [Medline].

  40. Schornagel IJ, Knol EF, van Weelden H, Guikers CL, Bruijnzeel-Koomen CA, Sigurdsson V. Diagnostic phototesting in polymorphous light eruption: the optimal number of irradiations. Br J Dermatol. Dec 2005;153(6):1234-6. [Medline].

Further Reading

Keywords

polymorphous light eruption, polymorphic light eruption, PLE, PMLE rash, idiopathic photodermatosis, reaction to sunlight, ultraviolet radiation exposure, UV-R exposure, erythema multiforme–like lesions

Contributor Information and Disclosures

Author

Noah S Scheinfeld, MD, JD, FAAD, Assistant Clinical Professor, Department of Dermatology, Columbia University; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Private Practice
Noah S Scheinfeld, MD, JD, FAAD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Optigenex Consulting fee Independent contractor

Coauthor(s)

Sophie Shirin, MD, Consulting Staff, Global Dermatology
Sophie Shirin, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Raul Del Rosario, MD, Consulting Staff, Surgical Pathology and Dermatopathology, South Coast Medical
Raul Del Rosario, MD is a member of the following medical societies: American Society for Clinical Pathology
Disclosure: Nothing to disclose.

Medical Editor

Craig A Elmets, MD, Director of Dermatology, Departments of Dermatology, Pathology, and Environmental Health Sciences; Professor, The Kirklin Clinic, University of Alabama at Birmingham
Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, and Society for Investigative Dermatology
Disclosure: Palomar Medical Technologies Stock None; Amgen Consulting fee Review panel membership; Astellas Consulting fee Review panel membership; Massachusetts Medical Society Salary Employment; Abbott Laboratories Grant/research funds Independent contractor

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey P Callen, MD, Professor of Medicine, Chief, Division of Dermatology, University of Louisville School of Medicine
Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Honoraria Consulting; Centocor Honoraria Consulting; Medicis Honoraria Consulting; Celgene Honoraria Consulting

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.