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Polymorphous light eruption and benign summer light eruption in Italy.

Marcella Guarrera¹, Pasquale Cardo, Alfredo Enrico Rebora

¹Department of Endocrinological and Medical Sciences, University of Genoa, Genoa, Italy. guarrera@unige.it

Photodermatology, Photoimmunology & Photomedicine

|January 5, 2011

Summary

Distinguishing benign summer light eruption (BSLE) from polymorphous light eruption (PLE) is challenging. Specific clinical criteria identified BSLE in a small minority of patients, often showing positive phototests, primarily to UVA radiation.

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Area of Science:

Dermatology
Photobiology
Immunodermatology

Background:

Polymorphous light eruption (PLE) is a common photodermatosis with suspected heterogeneity.
The existence and diagnostic criteria for benign summer light eruption (BSLE), a potentially distinct subtype of PLE, remain controversial.

Purpose of the Study:

To investigate the prevalence of clinical patterns associated with BSLE.
To identify criteria that reliably distinguish BSLE from PLE.
To evaluate the diagnostic utility of phototesting in differentiating these conditions.

Main Methods:

Retrospective analysis of 346 patients with suspected PLE across five Italian Photodermatology Centres.
Data collected included patient demographics, skin type, family history, atopy, and clinical presentation.
Standardized phototesting with UVA and UVB, photopatch testing, and antinuclear antibody (ANA) assessment were performed.

Main Results:

Applying four specific criteria (female predominance, shorter latency, no facial involvement, no summer relapse) identified BSLE in only 6.1% of cases.
Patients identified as BSLE consistently showed positive phototests, predominantly to UVA.
Alternative combinations of criteria identified varying percentages of patients, mostly with positive UVA phototests.

Conclusions:

Established clinical criteria diagnose BSLE in a small subset of patients presenting with light-induced eruptions.
Phototesting, particularly with UVA, appears crucial in supporting the diagnosis of BSLE in these selected cases.
Further research is needed to fully elucidate the distinct characteristics and diagnostic boundaries of BSLE within the spectrum of PLE.