A Study on Cell-Mediated Immunity in Polymorphic Light Eruption

Horkay, Irén; Krajczár, J.; Bodolay, Edit; Debreczeni, M; Bégány, Ágnes

doi:10.1159/000249840

Cited by 11 publications

(2 citation statements)

References 19 publications

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“…In Scottish studies, 20% of the cases occurred before 10 years of age (20) and 47% before 20 years of age (14), whereas in Finland (2) about 25% of the cases developed earlier than 15 years of age. In our material (398 PLE patients between 1967 and 2006), 4% of the cases manifested before 5 years of age and 10% between 6 and 14 years before adolescence (21).…”

Section: Idiopathic Photodermatosesmentioning

confidence: 76%

Photosensitivity skin disorders in childhood

Horkay

Emri

Varga

et al. 2008

Photoderm Photoimm Photomed

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SummaryPhotosensitivity in childhood is caused by a diverse group of diseases. It usually indicates idiopathic photodermatoses, first of all polymorphic light eruption. It may be an early symptom of genetic disorders such as porphyria or very rare genophotodermatoses. Photosensitivity secondary to topical or systemic external agents as well as photoexacerbated dermatoses is not so frequent in childhood. Here we present our experience with childhood photosensitivity skin diseases collected over a 40-year period. L ight-induced skin eruptions are not a common problem in pediatric dermatology. However, the condition often causes trouble and discomfort to the affected child and the parents.The literature on childhood photodermatoses (PDs) is relatively scanty. The incidence of PDs in childhood is much lower than in adults (1). According to the paper published by Jansén (2), photosensitivity started at the age of 15 years or earlier in 26% of the cases out of a total of 370 PD patients. There is also a shortage of primary data on the prevalence of PDs classified recently by Yashar and Lim (3) such as (i) idiopathic PD: polymorphic light eruption (PLE), juvenile spring eruption of the ears (JSE), solar urticaria (SU), hydroa vacciniforme (HV), (ii) photosensitivity secondary to exogenous agents, (iii) cutaneous porphyrias, (iv) genophotodermatoses and (v) photoexacerbated/aggravated disorders. The paper presents experience with PDs in childhood (83 cases) collected at the Department of Dermatology, Debrecen, between 1967 and 2006.The diagnosis in the vast majority of PD cases in children is PLE, whereas the order of other diseases is quite variable depending on geographic and genetic conditions. In the Finnish report (2) mentioned before, PLE was followed by xeroderma pigmentosum (XP) and then erythropoietic protoporphyria (EPP), while no cases were recorded from external photosensitizers. According to other literary data, phototoxic dermatitis occurs relatively often besides idiopathic PDs during childhood (4). Similar to these findings the most frequent diagnosis at our Department of Dermatology was also PLE. However, we recorded a rather high number of EPP cases and some porphyria cutanea tarda (PCT) as well, but only a few cases of XP (Table 1).Diagnosis of PD in childhood is not as easy as in adulthood (5). In the history occasionally (mostly in EPP) a family history is noted, such as in our patient material (6). The clinical picture is featured by various kinds of eruptions localized typically on the sun-exposed skin. The diagnosis in childhood can also be confirmed by phototests. Most informative is the provocation test used to reproduce lesions of idiopathic PDs (5). We perform it with ultraviolet (UV)B and UVA separately (Multitester SBB LT 400; Saalmann, Herford, Germany) (7) according to the protocol of Lehmann et al. (8). Photopatch testing for identifying external photosensitizer(s) is not performed commonly in children. We have not used it in our practice. Concerning laboratory tests, in porphyrias spect...

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Section: Idiopathic Photodermatosesmentioning

confidence: 76%

Photosensitivity skin disorders in childhood

Horkay

Emri

Varga

et al. 2008

Photoderm Photoimm Photomed

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“…Some investigators have also examined the possibility that PLE involves quantitative or qualitative lymphocyte disturbances that could indicate defective immunoregulatory mechanism in affected individuals. Transient decreases as well as increases in numbers of lymphocytes have been reported 52,53 . In one study, the number of T cells as well as their response to stimulation with phytohaemagglutinin, concavalin A, and a purified protein derivative of tuberculin were found to be normal in subjects with PLE before and after photochemotherapy 54 .…”

Section: Aetiology and Pathogenesismentioning

confidence: 96%

Polymorphous light eruption

Stratigos

Antoniou

Katsambas

2002

Acad Dermatol Venereol

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Polymorphous light eruption (PLE) is a common idiopathic photosensitivity disorder with an estimated prevalence of 10-20%. It is characterized by an intermittent skin reaction to ultraviolet (UV) radiation exposure, consisting of non-scarring pruritic erythematous papules, vesicles or plaques that develop on light-exposed skin. Despite the different morphology in different individuals, the eruption tends to have a monomorphous presentation in any single subject. The histopathological features of PLE are distinct and comprise a perivascular lymphocytic infiltrate in the dermis, subepidermal oedema and variable epidermal changes. The pathogenesis of PLE is not well known, but findings suggest that it is a delayed-type hypersensitivity reaction to one or more UV-modified cutaneous antigens. The principal action of PLE is mainly in the UVA region, although some subjects exhibit sensitivity to UVB alone or to both UVA and UVB radiation at the same time. Preventive measures in PLE include the regular use of photoprotective methods combined with graduated exposures to natural sunlight. The induction of immune tolerance by phototherapy and photochemotherapy are useful prophylactic methods in moderate to severe cases. The role of systemic agents in the management of PLE is under investigation. This article reviews the epidemiological, pathogenetic and clinical aspects of PLE and discusses recent advances in the diagnostic approach and management of this condition.

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Cutaneous Photosensitivity Diseases

Ibbotson

Dawe

2016

Rook's Textbook of Dermatology, Ninth Edition

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The photodermatoses are a diverse group of diseases, some of which, such as polymorphic light eruption, are very common and others, such as hydroa vacciniforme or xeroderma pigmentosum, are rare. It is essential not to miss the diagnosis of these conditions and referral to a specialist photodiagnostic centre is advised for many patients. Management depends on the diagnosis but includes prevention and disease suppression. Photoprotection is a mainstay approach for the photodermatoses but is often not sufficient for disease control. Desensitization using photo(chemo)therapy regimens may be feasible and systemic therapies are sometimes needed. Photosensitivity, particularly if chronic and severe, can be associated with significant psychological morbidity, which must be considered. Awareness of the possibility of vitamin D deficiency is also required.

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A Study on Cell-Mediated Immunity in Polymorphic Light Eruption

Cited by 11 publications

References 19 publications

Photosensitivity skin disorders in childhood

Photosensitivity skin disorders in childhood

Polymorphous light eruption

Cutaneous Photosensitivity Diseases

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