[11], PLE appears on areas of the skin newly exposed to sunlight such as the visible part of the neckline, backs of hands, arms and legs, and feet, but less commonly the face. It does not seem to be associated with systemic disease or drugs. Your healthcare provider can suggest ways to protect your skin from UV light and prevent PMLE. Reddy H, Carmichael AJ, Wahie S. Severity of polymorphic light eruption in pre- and post-menopausal women: a comparative study. doi: 10.1016/j.det.2014.03.012. Abstract. PMLE is not contagious. Its important to note that, while UVA exposure is the typical cause, the rash can be a result of UVA or UVB exposure. Photosensitivity. Explain that UV-A is a large component of sunlight and can cause the light eruption without sunburn (as sunburn is mainly due to UV-B). It occurs after solar or artificial UV-light exposure and affects only the sun-exposed areas with preference of the V-area of the chest, of arms and forearms, legs, upper part of the back, and rarely the face. Twin studies indicate a polygenic model may explain familial clustering. This exposes the skin to small doses of UVA or UVB light that helps your skin be less sensitive to light. Sunscreens. Dermatoses resulting from physical factors. Willan House, 4 Fitzroy Square, London, W1T 5HQ | admin@bad.org.uk | +44 (0)020 7383 0266 It also occurs more frequently in places that are at higher altitudes and in more temperate climates. This condition causes a red, itchy rash to form soon after youve been in the sun or exposed to artificial UV rays. Last reviewed by a Cleveland Clinic medical professional on 02/20/2023. A 20-year-old woman with fair skin presents with intensely itchy small papules on the V-shaped neck area and dorsal aspects of her arms. This means that glass windows wont provide enough protection from the sun to prevent a PMLE reaction. Can you prevent polymorphous light eruption? Polymorphous light eruption This eruption is a reaction to sunlight (primarily UVA light) that is not fully understood. It lasts for up to 2 weeks, healing without scarring. The rash typically lasts only 23 days, but some people may continue having symptoms throughout summer. Polymorphic light eruption occurs in 18% of Europeans and does not show higher prevalence with increasing latitude: multicenter survey of 6,895 individuals residing from the Mediterranean to Scandinavia. DermNet does not provide an online consultation service. //]]>. Clinical and therapeutic aspects of polymorphous light eruption. Boonstra HE, van Weelden H, Toonstra J, van Vloten WA. INTRODUCTION. It has been noted that PMLE appears to be less frequent and severe in women after menopause. Polymorphous light eruption (PMLE) is a common skin rash generally caused by exposure to the suns ultraviolet (UV) light. Unauthorized use of these marks is strictly prohibited. PLE is a relatively common skin disorder that is not easy to diagnose or manage. Hematoxylin-eosin staining shows subepidermal edema and a mixed, predominantly lymphoid perivascular infiltrate in the superficial and deep dermis. This does not cause a problem in unaffected individuals because of UV-induced suppression. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.aocd.org/page/PolymorphousLightE), (https://www.cdc.gov/nceh/features/uv-radiation-safety/index.html), (https://dermnetnz.org/topics/polymorphic-light-eruption), (https://www.nhs.uk/conditions/polymorphic-light-eruption/), (https://www.ncbi.nlm.nih.gov/books/NBK430886/). Seborrheic dermatitis commonly affects the skin on the chest, causing a red, scaly rash to appear. The test is repeated on the same site daily for 3 days and the area examined to detect the typical rash. Elmets CA. James WD, et al. The https:// ensures that you are connecting to the Polymorphous light eruption (PMLE). [15], Oxidative stress and the modification of the redox status of the skin has been implicated in the expression of PLE. It mimics the increased exposure you would experience during a summer. 60% of patients yielding a positive eruption are clinically and. Schweintzger N, Gruber-Wackernagel A, Reginato E, Bambach I, Quehenberger F, Byrne SN, Wolf P. Br J Dermatol. A provocative test in which UV radiation is used to confirm the diagnosis. The symptoms are usually self-limiting and go away after a few days. Its the most common skin condition caused by sunlight. Affected individuals may experience it every time they go outdoors, or only occasionally. Some patients have reported a response to UVC from welding arcs. A skin biopsy, or tissue sample, may be obtained to confirm the diagnosis. Gruber-Wackernagel A, Byrne SN, Wolf P. Polymorphous light eruption: clinic aspects and pathogenesis. This site needs JavaScript to work properly. Phototherapy Experts have suggested it may also be at least partly associated with: While the causes of PMLE are still under investigation, the rash is brought on by UV light. The lesions occurred on the third day of her spring break vacation by the sea. Polymorphic light eruption (PMLE) is a form of photosensitivity, which usually occurs in younger females. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Winter occurrences likely due to solariums (tanning facilities) or a holiday to a sunnier climate. Specialized centers may undertake photoprovocation testing in late winter, to determine inciting wavelengths. Its most pronounced during the spring and early summer. More people experience polymorphic light eruption at high altitude than at sea level.[1]. The rash most commonly appears on your: Juvenile spring eruption is a type of PMLE that tends to affect the ears of children (mostly boys). Heat rash is a painful condition that occurs in hot weather when sweat pores become blocked. The clinical presentation and the presence of massive dermal oedema can be helpful features. Estradiol may act as an inhibitor to the UV light immunosuppression which would normally aid in reducing hypersensitivity reactions. However, it can be triggered in some patients by UV-B or visible light. Venosa, A. In PMLE patients, UV radiation leads to an increased amount of CD4 and CD8 T lymphocytes, and an increased inflammatory response in the epidermis and dermis. https://melanomafoundation.org/melanoma-prevention. Polymorphous light eruption (PMLE) is a common skin rash that develops in people who are sensitive to ultraviolet (UV) light. Thus, a patient may benefit from a mental health counsultant. Kliegman RM, et al. [7] The resulting itch can cause significant suffering. J Am Acad Dermatol. Polymorphous light eruption is generallyuncomplicated but severe disease can lead to emotional distress, anxiety and depression. National Library of Medicine Some people may experience symptoms for longer than this, potentially all summer if they continue getting sun exposure, but this is uncommon. A study across Europe found that PMLE affects as much as 18 percent of the population there. Sun rash is a red, itchy rash that appears because of exposure to sunlight. Epub 2015 Jul 30. An unknown photoantigen is rendered immunogenic on exposure to UV. Polymorphous light eruption (PLE) is a common skin rash that occurs due to sunlight exposure. Schweintzger NA, Gruber-Wackernagel A, Shirsath N, Quehenberger F, Obermayer-Pietsch B, Wolf P. Photochem Photobiol Sci. Its most common among: Polymorphous light eruption typically presents as an itchy rash on sun-exposed areas of your body. Br J . If your symptoms are severe, your health care provider may prescribe anti-itch medicine (a corticosteroid cream or pill). [25][26], Danish physician Carl Rasch first described the eczema-like polymorphic light eruption in 1900, following his interest in the effect of sunlight on the skin. However, this test can lead to false negatives. This activity reviews the pathophysiology of polymorphic light eruption and highlights the role of the interprofessional team in its management. Please enable it to take advantage of the complete set of features! PMLE affects all ages, sexes, races and ethnicities. [2], The photosensitivity connected with lupus erythematosus is the main condition that may appear like PLE. You can learn more about how we ensure our content is accurate and current by reading our. DermNet provides Google Translate, a free machine translation service. When your skin is exposed to sunlight, a rash will form within a few hours or days. Topics AZ Broad-spectrum sunscreens provide better protection from solar ultraviolet-simulated radiation and natural sunlight-induced immunosuppression in human beings. Photohardening of polymorphic light eruption patients decreases baseline epidermal Langerhans cell density while increasing mast cell numbers in the papillary dermis. Polymorphic light eruption, Author(s): Dr Prudence Gramp, Dermatology Department, Gold Coast University Hospital, Australia. government site. [2], The cause of PLE is not yet understood, but several factors may be involved. Fig. Duteil L, Queille-Roussel C, Aladren S, Bustos X, Trullas C, Granger C, Krutmann J, Passeron T. Dermatol Ther (Heidelb). There are often lymphocytes in the epidermis (exocytosis, figure 3). This involves exposure of 5-cm squares of usually-affected skin to 12 minimal erythema doses (MED) of broadband UVB and to varying doses of UVA. Yet they can take some steps to reduce the symptoms, such as: If a person develops a rash suddenly, they should speak with a doctor for a diagnosis. However, positive antinuclear antibody and extractable nuclear antigen (anti-Ro/La) in low titer may be detected, even in the absence of other criteria to suggest a diagnosis of lupus erythematosus. They will also perform a physical examination of the skin. Doctors think it is a type of delayed allergic reaction. Polymorphous light eruption (PMLE) is an acquired disease and is the most common of the idiopathic photodermatoses. Yoon HS, Shin CY, Kim YK, Lee SR, Chung JH. Your health care provider might have you undergo laboratory tests in order to confirm a diagnosis or rule out other conditions. Have you had a similar rash before? Merck Manual Professional Version. Exposure to sunlight in spring or summer results in an irritable rash that resolves within a few days, providing further exposure is avoided. The rash usually appears as tiny, inflamed bumps or slightly raised patches of skin. The putative antigen induced by UV radiation leads to a predominance of CD4+ T cells and the production of proinflammatory cytokines such as interleukin (IL) 1. Your first eruption of the year may be the most severe, with following eruptions progressively subtler. 2008 May;58(5 Suppl 2):S149-54. The epidermal changes range from being almost normal to showing impressive spongiosis and acanthosis. [2], Artificial UV light sources from tanning units and phototherapy treatment units can also trigger PLE. Keywords: The problem takes many forms, though it often appears as a red, itchy rash on areas exposed to the sun, except for the face. The morphology can include eruptions that are: The morphology is, however, always the same in one patient. We avoid using tertiary references. Other light eruptions and eczematous reactions Photoallergic reactions and contact dermatitis can show a dense lymphocytic infiltrate to resemble PMLE. doi:10.1111/jdv.12470. Accessed Dec. 9, 2021. Look for clothes labeled with an ultraviolet protection factor (UPF) of 40 to 50. While the rash varies from person to person, the particular rash you get will typically be similar every time it happens. Its not as common, but you might have additional symptoms, like: Polymorphic means many forms, and PMLE can look different for different people. PMLE often occurs in the spring when sunny weather returns. MeSH The condition is more frequent in females and begins often in young adults and in mid-adult life. Learn more about the condition and its treatments here. PCOS may cause menstrual cycle changes, skin changes such as increased facial and body hair and acne, abnormal growths in the ovaries, and infertility. An official website of the United States government. Accessed Dec. 9, 2021. Gruber-Wackernagel A, et al. PMLE is usually diagnosed based on its symptoms, primarily the appearance of the rash when it occurs, where its located, and how quickly it heals. [6]. Your skin can build up a tolerance to UV light throughout the summer, but this will go away during the winter. This can explain why it is uncommon to get PMLE in areas of the face or hands due to their chronic exposure to the sun compared to other areas of the body. J Invest Dermatol. People may wish to try this approach at home by eating more fresh produce that is yellow, orange, or red. In most patients with a polymorphic light eruption, blood tests willreveal normal results. The patient is exposed ideally to UVA (alternatively UVB) daily for 35 days to a small area of skin (such as the forearms or v of neck), which elicits an eruption. UV-A is a major constituent of sunlight, can pass through glass, is relatively resistant to sunscreen and can cause light eruption without sunburn. (2021). 2017 Nov 1;35(6):751-757. doi: 10.1016/j.biotechadv.2017.07.006. 5th ed. [10] Further episodes of the irritable rash occur several hours to days following subsequent sun exposure. What to wear to protect your skin from the sun. : Clinical Dermatology. J Invest Dermatol. For polymorphous light eruption, some basic questions to ask your health care provider include: Your health care provider will ask you a number of questions about your symptoms and your medical history, such as: Avoid sun exposure whenever possible. In: Weedon's Skin Pathology. Polymorphic light eruption (PMLE) is a seasonal, acquired, idiopathic photodermatosisoccurring in spring and early summer. Its also called polymorphic light eruption and prurigo aestivalis. Polymorphous light eruption (PMLE) is an allergic reaction to sunlight or other sources of ultraviolet (UV) light. Polymorphic light eruption Four times more common in women than men. [15], Other similar appearing conditions are solar urticaria, which has a shorter duration, the eczema-like condition, photosensitive dermatitis,[2] and photosensitivity drug reaction. Lembo S, et al. This is a type of distinct, circular bump that occurs due to, Erythema multiforme causes a distinctive rash resembling a bull's-eye.
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