Summary
Definition
History and exam
Key diagnostic factors
- recurrent history of lesions following ultraviolet radiation exposure
- young women and adolescents
- family history of PLE
- severe itching
- reduced symptoms over the course of a year
- erythematous patches
- papules
- plaques
- vesicles
Risk factors
- ultraviolet A exposure
- oxidative stress/reactive oxygen species
- family history of PLE
- female sex
Diagnostic tests
Tests to consider
- phototesting and photoprovocation
- skin biopsy
Treatment algorithm
papular type (typical PLE) and plaque type with few small plaques
plaque type with widespread thick plaques + vesiculobullous variant
Contributors
Authors
Anusuya Kawsar, MBBS, BMedSci (hons), MRCP
Dermatology Registrar
Hammersmith Hospital
Imperial College Hospitals NHS Trust
London
UK
Disclosures
AK declares that she has no competing interests.
Shirin Zaheri, MBBS, BSc, MRCP
Consultant Dermatologist
Charing Cross/Hammersmith Hospital
Imperial College Hospitals NHS Trust
London
UK
Disclosures
SZ declares that she has no competing interests.
Acknowledgements
Dr Anusuya Kawsar and Dr Shirin Zaheri would like to gratefully acknowledge Dr Mieran Sethi, Dr Catherine Hardman, Dr Sarah Hogan and Dr Ina Marion Hadshiew, previous contributors to this topic. MS has been reimbursed by Vichy and La Roche Posay for presenting video clips and attending conferences about skin disease. CH, SH and IMH declare that they have no competing interests.
Peer reviewers
Erhard Holzle, MD
Professor and Chair
Department of Dermatology
Stadtische Kliniken
Oldenburg
Germany
Disclosures
EH declares that he has no competing interests.
References
Key articles
Burfield L, Rutter KJ, Thompson B, et al. Systematic review of the prevalence and incidence of the photodermatoses with meta-analysis of the prevalence of polymorphic light eruption. J Eur Acad Dermatol Venereol. 2023 Mar;37(3):511-20.Full text Abstract
Ling TC, Dawe RS, Gardener E, et al. Interventions for polymorphic light eruption. Cochrane Database Syst Rev. 2017 Oct 9;2017(10):CD005069.Full text
Goulden V, Ling TC, Babakinejad P, et al. British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022. Br J Dermatol. 2022 Sep;187(3):295-308.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Photoallergic reaction
- Phototoxic reaction
- Chronic actinic dermatitis
More DifferentialsGuidelines
- Narrowband ultraviolet B phototherapy
- Sunlight exposure: risks and benefits
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