Polymorphous light eruption is an immunologically mediated photodermatosis with high prevalence, particularly among young women in temperate climates, characterized by pruritic skin lesions of variable morphology, occurring in spring or early summer on sun-exposed body sites. A resistance to ultraviolet radiation (UVR)-induced immunosuppression and a subsequent delayed-type hypersensitivity response to a photoantigen have been suggested as key factors in the disease. Molecular and immunologic disturbances associated with disease pathogenesis include a failure of skin infiltration by neutrophils and other regulatory immune cells on UVR exposure linked to a disturbed cytokine microenvironment. Standard management is based on prevention.
Key points
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PMLE is the most common form of photodermatosis, with a prevalence of up to approximately 20%, particularly among young women in temperate climates.
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PMLE is characterized by pruritic skin lesions of variable morphology, occurring in spring or early summer on sun-exposed body sites; although PMLE lesions are self-limited and nonscarring, patients can experience significant discomfort and loss of quality of life.
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A resistance to ultraviolet radiation–induced immunosuppression (ie, a physiologic phenomenon in healthy subjects) and a subsequent delayed-type hypersensitivity response to a photoantigen have been suggested as key factors in the disease.
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Standard management is based on prevention through medical photohardening with UVB radiation and protection by broad-band sunscreens and clothing, and treatment of symptoms with topical and/or systemic steroids.
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Novel prophylactic and/or therapeutic treatment includes substances with antioxidant and anti-inflammatory properties or those that interfere with melanization in the skin, DNA repair, or vitamin D pathway.
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