Onset occurs during adolescence and young adulthood.
Mainly affects women.
Typically, manifests after exposure to intense ultraviolet radiation (UVR); clinical symptoms last several days and remission occurs without complication.
Papules/papulovesicles and plaques on exposed sites are characteristic.
Topical corticosteroid creams or lotions are the mainstay of therapy, with the addition of oral corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) in severe disease.
Prophylaxis is an important part of management with avoidance of sun exposure, physical UVR protection, and light hardening.
Polymorphous light eruption (PLE) is a benign skin disease that occurs in genetically predisposed people after exposure to ultraviolet radiation (UVR). Clinical signs include severe itching and small papules, plaques, and papulovesicles on predilection sites, such as the V-shaped neck area, dorsal aspects of the arms, hands, legs, and less commonly on the face. Etiology remains elusive; however, longer wavelength UVR (315-400nm) induced oxidative stress appears to play a key role.
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
- ultraviolet A exposure
- oxidative stress/reactive oxygen species
- family history of PLE
- female sex
Investigations to consider
- phototesting and photoprovocation
- skin biopsy
papular type (typical PLE) and plaque type with few small plaques
plaque type with widespread thick plaques + vesiculobullous variant
Mieran Sethi, MBBS, BSc, MRCP, PhD
St Mary's Hospital
MS has been reimbursed by Vichy and La Roche Posay for presenting video clips and attending conferences about skin disease.
Shirin Zaheri, MBBS, BSc, MRCP
Charing Cross/Hammersmith Hospital
Imperial College Hospitals NHS Trust
SZ has received honoraria for speaking at, facilitating and/or attending meetings/advisory boards from L'Oreal, AbbVie, and Eli Lilly, and has had expenses sponsored for attending meetings by Leo, Novartis, L'Oreal and Naos.
Dr Mieran Sethi and Dr Shirin Zaheri would like to gratefully acknowledge Dr Catherine Hardman, Dr Sarah Hogan and Dr Ina Marion Hadshiew, previous contributors to this topic. CH, SH and IMH declare that they have no competing interests.
Erhard Holzle, MD
Professor and Chair
Department of Dermatology
EH declares that he has no competing interests.
- Photoallergic reaction
- Phototoxic reaction
- Chronic actinic dermatitis
- British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen-ultraviolet A therapy 2015
- Sunlight exposure: risks and benefits
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