[6] It is thought to be due to a type IV delayed-type hypersensitivity to an allergen produced in the body following sunlight exposure,[12] in a genetically susceptible person. Describe the pathophysiology of polymorphic light eruption. Seborrheic dermatitis commonly affects the skin on the chest, causing a red, scaly rash to appear. In short, jock itch can spread between, Keloids can appear on your ear in response to any type of wound, including a piercing. and transmitted securely. Skin diseases due to physical and chemical causes", https://en.wikipedia.org/w/index.php?title=Polymorphous_light_eruption&oldid=1127125983, Skin conditions resulting from physical factors, Pages containing links to subscription-only content, Creative Commons Attribution-ShareAlike License 3.0, Shortly after sun exposure in people younger than age 30-years, This page was last edited on 13 December 2022, at 01:14. Learning Point. Polymorphic Light Eruption Article - StatPearls PMLE is not contagious. Kittler H, Hnigsmann H, Tanew A: Antinuclear antibodies in patients with polymorphic light eruption: a long-term follow-up study. Polymorphous Light Eruption - Medscape It is postulated that there is a delayed hypersensitivity reaction to an endogenous antigen expressed after exposure to sunlight or artificial sources of ultraviolet (UV) radiation. Some people with PLE may find they react to even small exposures to sunlight, while others develop PLE only after a certain amount of time in the sun or as a result of repeated exposures. Dermatologic clinics. The lesions occurred on the third day of her spring break vacation by the sea. Melanoma prevention. Polymorphous light eruption (PMLE) is an allergic reaction to sunlight or other sources of ultraviolet (UV) light. All rights reserved. PMLE is characterized by recurrent, abnormal, delayed reactions to sunlight, ranging from erythematous papules, papulovesicles, and plaques to erythema multiforme -like lesions on sunlight-exposed surfaces. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.12470. Journal of the European Academy of Dermatology and Venereology : JEADV. Experts dont know exactly what causes this rash. [2], Photoprovocation tests are usually not required but may be undertaken by specialised centres in winter. Prevention of Polymorphic Light Eruption Afforded by a Very High Broad-Spectrum Protection Sunscreen Containing Ectoin. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. [4], PLE is more common in young adults and has a female preponderance[5] with a ratio of 2:1 female-to-male. Several hours to days later, an irritablerash appears on areas newly exposed to the light such as the dcolletage, forearms, backs of hands, lower legs and feet. She spent most of her time on the beach, in the shade. A PLE rash does not usually leave scars or marks. Direct immunofluorescence testing is negative. If in doubt, call a doctor. Polymorphic light eruption (PMLE) is a rash which comes on after being in strong sunlight. Polymorphic light eruption tends to recur annuallyand is somepatients persists throughout the year, depending on latitude. Women between 20 and 40 with pale skin are the most affected, but anyone can have PMLE. Affected individuals may experience it every time they go outdoors, or only occasionally. Theories must account for increased prevalence in women and for the hardening effect of on-going exposure to ultraviolet radiation. Look for clothes labeled with an ultraviolet protection factor (UPF) of 40 to 50. If you develop a rash shortly after exposure to sunlight or artificial UV light, ask a healthcare provider if you could have polymorphous light eruption (PMLE). Elsevier; 2020. https://www.clinicalkey.com. ncbi.nlm.nih.gov/pmc/articles/PMC7379702/, ncbi.nlm.nih.gov/pmc/articles/PMC8323194/, ncbi.nlm.nih.gov/pmc/articles/PMC6139322/, dermnetnz.org/topics/polymorphic-light-eruption, nhs.uk/conditions/polymorphic-light-eruption/, aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/what-to-wear-protect-skin-from-sun, Every Sunscreen Question You Have, Answered, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. However, continual sun or UV exposure can make the rash worse. doi:10.1016/j.jaad.2009.01.041. Policy. 2023 Healthline Media UK Ltd, Brighton, UK. [4]Neutrophils may be seen in early lesions. However, this test can lead to false negatives. These are good practices for everyone, with or without PMLE. There are several types of "sun allergies," but polymorphous light eruption (PMLE), an autoimmune condition in the skin that occurs after sun exposure, is one of the most common. This site needs JavaScript to work properly. Recognizing and preventing sun allergies - Harvard Health ago. Polymorphic light eruption: What's new in pathogenesis and management. Photodermatol. sharing sensitive information, make sure youre on a federal This condition causes a red, itchy rash to form soon after youve been in the sun or exposed to artificial UV rays. Disclaimer. [9], Blood tests are usually normal. [9], Prickly heat, which is caused by warm weather or heat is not the same as PLE. A positive family history in some patients suggests a genetic risk factor. 2000 Feb;42(2 Pt 1):199-207. doi: 10.1016/S0190-9622(00)90126-9. If youre going someplace sunny on vacation, your healthcare provider may prescribe an oral corticosteroid like prednisone to reduce your chances of getting a rash. Last medically reviewed on November 23, 2022, An atypical skin reaction to sun exposure causes a sun rash. Idiopathic photodermatosis; Immunomediated photodermatosis; Minimal erythema dose; Photoprovocation tests; Phototests; Polymorphous light eruption; UV light. PMLE can be seen in all races and all skin types. Find out if kids need different sunscreens from adults, if sunscreen can be toxic, and whether it matters if youre slathering on SPF 100. [2], Another treatment option is a supervised course of low dose phototherapy, usually undertaken in winter. The histopathology of PMLE is nonspecific, variable, and can include: Direct immunofluorescence is negative in PMLE. This typically has to be repeated after every winter. The rash persists for several days then clears up without scarring if further exposure to UV is avoided. Your health care provider might have you undergo laboratory tests in order to confirm a diagnosis or rule out other conditions. UVA causes up to 9 in 10 cases of polymorphous light eruption. 2016 Mar;15(3):440-6. doi: 10.1039/c5pp00398a. PMLE often occurs in the spring when sunny weather returns. Careers. Estradiol may act as an inhibitor to the UV light immunosuppression which would normally aid in reducing hypersensitivity reactions. Heat rash is a painful condition that occurs in hot weather when sweat pores become blocked. As the name suggests, clinical features can vary poly meaning many, morphic meaning forms. Its most pronounced during the spring and early summer. Summarize the importance of improving care coordination among interprofessional team members to improve outcomes for patients affected by polymorphic light eruption. [16], The cases of this condition are most common between the spring and autumn months in the northern hemisphere and at higher altitudes. Polymorphic light eruption is also known as polymorphous light eruption and prurigo aestivalis. Eye. Polymorphous light eruption is typically diagnosed with a thorough health history and skin examination. [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. 2008 Aug;24(4):164-74. doi: 10.1111/j.1600-0781.2008.00365.x. Norris PG, Morris J, McGibbon DM, Chu AC, Hawk JL. This roundup covers our top picks for best scar creams, from the best overall to creams for postsurgery, old scars, and fading discoloration. It is more common in Northern Europe (15% in the UK) than in Australasia (5%). Dermatologic clinics. The cause of polymorphic light eruption is unknown. When in situations that are likely to provoke the rash, cover up as much as possible with densely woven clothing. Distribution can include areas exposed to sunlight such as the arms, lower legs, V of the neck, and the chest. Your health care provider can probably make a diagnosis of polymorphous light eruption based on a physical exam and your answers to questions. Without additional exposure it will heal on its own. [1], The prevalence of polymorphic light eruption varies worldwide. Dermatologists can expose you to UV light a few times per week before the sun becomes strong in the spring to help avoid severe PMLE. It is more common in patients who receive only intermittent sun exposure and typically consists of crops of papules, vesicles or plaques. A 2014 study suggests that nutrition may also play a role in how sensitive a persons skin is to sun exposure. This can be done through careful and measured exposure to sunlight, or it can be achieved through the use of phototherapy. However, once the diagnosis is made, the patient may be monitored by the primary care physician and nurse practitioner. Polymorphous light eruption (PMLE). Both ultraviolet and occasionally visible light cause PMLE. People with the condition usually experience symptoms at the same time of year, often when the skin first becomes exposed to sunlight after being covered up during winter. Have you had a similar rash before? 2010;62(1):1501. Unauthorized use of these marks is strictly prohibited. Juvenile spring eruption is a variant of PMLE. Accessed Dec. 9, 2021. The eruption appears first on limited areas, but becomes more extensive during subsequent summers. Polymorphous light eruption - Case history | BMJ Best Practice US The eruption can appear within hours of sun exposure and last for days. Accessed Nov. 12, 2021. Blood tests might also be used to rule out other conditions. Ultraviolet radiation causes less immunosuppression in patients with polymorphic light eruption than in controls. 2014 Jul; [PubMed PMID: 24891050], Combalia A,Fernndez-Sartorio C,Fust X,Morgado-Carrasco D,Podlipnik S,Aguilera P, Successful Short Desensitization Treatment Protocol with Narrowband UVB Phototherapy (TL-01) in Polymorphic Light Eruption. It may affect up to 15% of people worldwide. 8600 Rockville Pike Rhodes LE, Bock M, Janssens AS, et al. Patterson JW. Your provider may refer to this as hardening the skin. You should only attempt this type of desensitization while under your providers care. Treatment of polymorphous light eruption usually isn't needed because the rash usually goes away on its own within 10 days. This means that, as youre exposed to UV light, your skin can build up a UV tolerance. The rash typically lasts only 23 days, but some people may continue having symptoms throughout summer. Low-dose narrowband UV-B and other forms of phototherapy undertaken in late winter or early skin can reduce the incidence and severity of polymorphous light eruption. Gradually exposing the skin to the sun, wearing adequate sun protection, and avoiding substances that increase photosensitivity may help prevent PLE or reduce the symptoms. Photodermatol Photoimmunol Photomed. Its also called polymorphic light eruption and prurigo aestivalis. 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. For utmost sun protection, use your sunscreen before the stated expiration date. [7][8](Level V), Gruber-Wackernagel A,Byrne SN,Wolf P, Polymorphous light eruption: clinic aspects and pathogenesis. Most UV light you are exposed to comes from the sun. Majoie IML, van Weelden H, Sybesma IM, Coenraads PJ, Sigurdsson V. Polymorphous light eruption-like skin lesions in welders caused by ultraviolet C light. UV-A, unlike UV-B, can penetrate window glassand is less well blocked by sunscreens. Author: A/Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013. Using high SPF, broad-spectrum sunscreen, and wearing protective clothing helps minimize UV light exposure. Therapy is based mainly on topical or systemic corticosteroids. In: Weedon's Skin Pathology. Sometimes, these papules appear in a dense formation, making the rash look similar to eczema or prickly heat. An official website of the United States government. Eruption refers to the sudden onset of the rash, usually within 30 minutes of UV light exposure. A rash can be a symptom of many different conditions. First described by Ebstein in 1942 as prurigo aestivalis. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. 2008 Aug; [PubMed PMID: 18510674], Papular polymorphic light eruption on lower legs in female. This rash is also known as PMLE, sun allergy or sun poisoning. Sunscreens containing the broad-spectrum UVA absorber, Mexoryl SX, prevent the cutaneous detrimental effects of UV exposure: a review of clinical study results. The following factors must be considered when determining pathogenesis and when implementing protective measures: UV radiation usually creates an immunosuppressive response in the skin, however, patients with PMLE may have a reduction in this normal response. Unable to load your collection due to an error, Unable to load your delegates due to an error. Epub 2014 Mar 27. This site needs JavaScript to work properly. How is polymorphous light eruption diagnosed? [6], It has been suggested that an undefined endogenous or exogenous photo-allergen may trigger a delayed immune reaction resulting in PLE. Polycystic Ovary Syndrome (PCOS) Polycystic ovary syndrome, or PCOS, is a set of symptoms related to a hormonal imbalance that can affect women and girls of reproductive age. For protection from the sun, wear tightly woven clothing that covers your arms and legs. [9], The diagnosis of PLE is typically made by assessing the history and clinical observations. Get useful, helpful and relevant health + wellness information. Dermatology Made Easybook. Skin lesions typically appear within hours of sun exposure, but they sometimes occur days later. [4], Treatments include prevention with sun avoidance and supervised light therapy, and symptom control with topical steroids. Polymorphous light eruption: MedlinePlus Medical Encyclopedia FOIA American Melanoma Foundation. Photosensitivity. Your skin can build up a tolerance to UV light throughout the summer, but this will go away during the winter. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://dermnetnz.org/topics/polymorphic-light-eruption, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8323194/, https://onlinelibrary.wiley.com/doi/10.1111/phpp.12093, https://www.ncbi.nlm.nih.gov/books/NBK430886/, https://www.nhs.uk/conditions/polymorphic-light-eruption, https://www.aocd.org/page/PolymorphousLightE, https://www.skincancer.org/skin-cancer-prevention/sun-protection/, https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/what-to-wear-protect-skin-from-sun, https://www.skincancer.org/blog/what-you-need-to-know-about-photosensitivity/, One-hour endoscopic procedure could eliminate the need for insulin for type 2 diabetes, New clues to slow aging? 1 mo. Avoidance of activities due to concern for flares with sun-exposure, If sun avoiding, there is a risk of vitamin D deficiency. 2022 Jul;12(7):1603-1613. doi: 10.1007/s13555-022-00755-5. Follow care instructions on the label of UV-blocking clothes to maintain their protective feature. The papular type is the most common. arrow-right-small-blue However, it may be genetic. Polymorphic light eruption. National Library of Medicine Healthline Media does not provide medical advice, diagnosis, or treatment. Its important to note that, while UVA exposure is the typical cause, the rash can be a result of UVA or UVB exposure. Mayo Clinic. This may explain why females are much more likely to develop PLE than males, as they have more estrogen. The British journal of dermatology. Photodermatoses - Knowledge @ AMBOSS It's less likely to be repeated as the summer . Polymorphous light eruption: Pictures and treatments - Medical News Today Exposure to sunlight in spring or summer results in an irritable rash that resolves within a few days, providing further exposure is avoided. [6]. James WD, et al. // Is it possible this condition is related to a more serious illness? Polymorphic Light Eruption (PLE) (also known as polymorphous light eruption and benign summer light eruption) is a recurrent, itchy skin eruption occurring on exposed skin sites after sun exposure, which heals without scarring within 14 days ().The presenting skin eruption is most commonly spots and blisters but may also take other forms, including plaques (raised . 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. There is a phenomenon called the skin hardening effect where chronic exposure to sunlight leads to skin changes including increased melanin and thickening of the stratum corneum. More people experience polymorphic light eruption at high altitude than at sea level.[1]. Language links are at the top of the page across from the title. PMLE starts to fade in a couple of days and goes away without treatment in a few weeks. Gramp, P. (2022). Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. This may suggest a genetic component, but researchers have not proven this. Direct immunofluorescence testing is negative. What treatments are available, and which do you recommend? Morphology variesbetweenindividualsand can include macules, vesicles, lichenoid plaques, prurigo papules and targetoid lesions resembling erythema multiforme. HHS Vulnerability Disclosure, Help Polymorphous light eruption (PMLE) is an acquired disease and is the most common of the idiopathic photodermatoses. Would you like email updates of new search results? [1]. In: Andrews' Diseases of the Skin. Any investigations are usually to exclude other conditions, particularly lupus and porphyria. PMLE is characterized by recurrent, abnormal, delayed reactions to sunlight, ranging from erythematous papules, papulovesicles, and plaques to erythema multiforme -like lesions on sunlight-exposed surfaces. Dummer R, Ivanova K, Scheidegger EP, Burg G. Dermatology. It may range from small red dots to clear fluid-filled dots (vesicles), eczema-looking dry patches, large plaques/papules, or target-like lesions. See additional information. Careers. Winter occurrences likely due to solariums (tanning facilities) or a holiday to a sunnier climate. Have you recently used a tanning bed or lamp? Venosa, A. It affects all skin types but is more common in lighter skin especially Fitzpatrick skin phototype 1, than in darker skins. A skin biopsy, or tissue sample, may be obtained to confirm the diagnosis. The https:// ensures that you are connecting to the Merck Manual Professional Version. There may also be a link with estrogen, according to the 2022 review. 2014 Jul; [PubMed PMID: 24891054], Lembo S,Raimondo A, Polymorphic Light Eruption: What's New in Pathogenesis and Management. Dermatoses resulting from physical factors. [15] Hence, it is less common near the equator. INTRODUCTION. The reaction usually happens during spring and early summer when exposure to sunlight increases.

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