Prognosis
Generally, PLE resolves without treatment; also, PLE irritations generally leave no scar.There may be a possible link with autoimmune thyroid disease. Some progression to autoimmune disease has been observed. However, another study of people with elevated titres of antinuclear antibodies with PLE found no progression to lupus erythematosus after an 8-year follow-up. Epidemiology
In the United States, whilst one-quarter of people being investigated for a photosensitivity disorder were diagnosed with PLE, the prevalence in the general population is 10 to 15% and may even be as high as 40% as suggested in one study of more than 2000 people. It is also particularly more prevalent in Central Europe and Scandinavia.PLE is more common in young adults and has a female preponderance with a ratio of 2:1 female-to-male. In Germany the female to male ratio has been cited as 9:1. It can, however, occur in all age groups and all skin types.Those experiencing sun exposure all year round seldom acquire PLE eruption. Hence, it is less common near the equator.The cases of this condition are most common between the spring and autumn months in the northern hemisphere and at higher altitudes. Society and culture
Reports of psychological distress have been made in more than 40% of peoples with PLE.
Classification
Sunlight has been documented to trigger numerous skin conditions and the confusing terminology and categorisation previously has made the correct diagnosis and subsequent treatment difficult.Variants of PLE have been described:
Juvenile spring eruption is a cutaneous condition that affects the helices of the ears, particularly in boys, because their ears are relatively more exposed to sunlight. Benign summer light eruption is a cutaneous condition, and a name used in continental Europe, particularly France, to describe a clinically short-lived, itchy, papular eruption particularly affecting young women after several hours of sunbathing at the beginning of summer or on sunny vacations. Actinic Prurigo is a hereditary form of PLE occurring typically in Native Americans. Treatment
Management entails regulating triggers whilst simultaneously inducing "hardening"; that is, steadily increasing exposure to sunlight, as light sensitivity is reduced with repeated sun exposureCovering up with densely woven clothing has also been shown to help, in addition to applying a broad-spectrum, water-resistant semi-opaque sun protection factor (SPF) 50+ sunblock cream before sun exposure and then every two hours thereafter confers some protection.The application of topical corticosteroids may lessen the redness and itch, and for preventing predictable holiday flare-ups, short courses of oral corticosteroids are sometimes considered.Another treatment option is a supervised course of low dose phototherapy, usually undertaken in winter. If resistant, the administration of hydroxychloroquine in early spring is sometimes considered.As sun exposure is avoided, vitamin D levels may fall and hence supplements are sometimes advised.