Frequency of occurrence of polymorphic light eruption in patients treated with photohardening and patients treated with phototherapy for other diseases

Abstract

Background Medical phototherapy can lead to the manifestation of polymorphic light eruption (PLE), though little is known about the frequency of such events. Aims The aim of this Austrian single center study was to retrospectively investigate over a 4‐year time period the frequency of PLE in patients prone to the condition and patients with other diseases under phototherapy (mainly narrow‐band and broad‐band UVB). Materials and Methods The data for analysis were obtained from the electronic health and patient record database and patient files of the Photodermatology Unit, Department of Dermatology, Medical University of Graz, Austria. Results PLE occurred in 24.3% (18/74) of PLE patients but only 0.7% (3/421) of psoriasis patients under phototherapy (chi‐square; P < 0.0001). PLE also occurred in 1.2% (3/257) of patients with atopic eczema, 0.8% (1/118) with prurigo, 3.5% (4/115, P = 0.0206) with parapsoriasis en plaques/mycosis fungoides, 7.4% (2/27, P = 0.0013) with granuloma anulare, 14.3% (1/7, P = 0.0002) with scleroderma, and 16.7% (1/6, P < 0.0001 vs. psoriasis) with pityriasis lichenoides chronica or pityriasis lichenoides eruptiva et varioliformis acuta. Discussion and Conclusion These results are helpful for treatment allocation and risk estimation of PLE occurrence with regard to obtaining informed consent not only from PLE‐prone patients but also from patients with other skin disorders commonly treated by phototherapy.

British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022

“…Polymorphic light eruption (PLE) may develop during treatment with NB‐UVB. In a retrospective survey, the provocation rate with NB‐UVB was 19·5% in 113 patients with PLE, compared with 0·7% in 974 patients with other diagnoses 71 . In the event of flaring, dose reduction and cautious escalation help to lower PLE recurrence.…”

“…In a retrospective survey, the provocation rate with NB-UVB was 19Á5% in 113 patients with PLE, compared with 0Á7% in 974 patients with other diagnoses. 71 In the event of flaring, dose reduction and cautious escalation help to lower PLE recurrence. The application of a potent topical steroid to commonly affected sites immediately following each treatment may further reduce the incidence.…”

Long-Term Course of Polymorphic Light Eruption: A Registry Analysis

“…As summer progresses, many individuals experience a hardening effect after repeated exposure (2,7,8), making skin lesions less likely to occur or less severe. Unfortunately, this natural photohardening effect as well as the hardening effect of prophylactic medical phototherapy are lost in winter; consequently, PLE lesions recur the next year and often for years to come (2,9,10).…”

Atypical coexistence of polymorphic light eruption and eruptive lichen planus in a patient with necrobiosis lipoidica

“…Polymorphic light eruption (PMLE) is the most common type of photodermatosis, prevalent particularly among young women living in temperate climate zones [1,2]. The disease is characterized by the intermittent occurrence of non-scarring, itchy, polymorphic erythematous-papular-vesicular rash or plaques in areas exposed to ultraviolet (UV) radiation [3].…”

“…Dermatology Review/Przegląd Dermatologiczny 2021/5 WPROWADZENIE Wielopostaciowe osutki świetlne (polymorphic light eruptions -PMLE) są najczęstszą fotodermatozą, szczególnie rozpowszechnioną wśród młodych kobiet, mieszkających w klimacie umiarkowanym [1,2]. Choroba charakteryzuje się okresowym występowaniem swędzącej, wielopostaciowej, niebliznowaciejącej osutki rumieniowo-grudkowo-pęcherzykowej lub blaszek pojawiających się w okolicach eksponowanych na działanie promieniowania ultrafioletowego (UV) [3].…”