Occurrence of polymorphous light eruption in lupus erythematosus

Abstract

Photosensitivity is a well-known manifestation of lupus erythematosus (LE). Since there are no strict criteria for photosensitivity, varying prevalence figures have been reported. Also, distinction from polymorphous light eruption (PLE) can be difficult. The purpose of this study was to characterize photosensitivity in more detail and to determine the occurrence of PLE in a series of well-documented LE patients. A questionnaire was answered by 337 LE patients seen at dermatology departments in Finland and Sweden, and 63 of the patients were invited for interview. According to the questionnaire, LE lesions were made worse by sunlight in 242 (72%) patients. Symptoms consistent with PLE were reported by 165 (49%) patients. Detailed personal interviews supported the results from the questionnaire, and revealed that PLE had started 2-45 years before the onset of LE in 23 of 37 patients with both diagnoses, and more than 7 years before in 18 of 37 (49%). PLE proved to be common in patients with both systemic and cutaneous LE. The two conditions may often coexist and, in about half of the cases, PLE preceded LE. These two diseases may share pathogenic factors. PLE might predispose to LE in a subgroup of PLE patients.

Early Detection of Epidermal Dust-like Particles in Experimentally UV-induced Lesions in Patients with Photosensitivity and Lupus Erythematosus

“…All of these patients had reported light sensitivity in a questionnaire (11). Two healthy females without any known photosensitivity served as controls (JL, SF).…”

“…Using UVA and UVB, the aim of this study was to investigate the early immuno£uorescence ¢ndings in experimentally induced skin lesions in a group of photosensitive LE patients (10,11).…”

Cutaneous lupus erythematosus: clinical features, prognosis and laboratory findings

“…In SLE patients, the presence of anti-SS-A antibodies correlates with photosensitivity, as well as cutaneous SCLE eruptions. Polymorphic light eruption (PLE) may present with similar clinical symptoms, although the immunological phenomena with anti-Ro/SSA antibodies as a characteristic trait of SCLE are usually missing [41,42]. The relation of both disease entities and their disease course is still a matter of debate.…”

“…However, photosensitivity appears to be a characteristic trait of SCLE and, less prominently, of DLE [62]. Following this concept, UV exposure will induce apoptotic processes within the epidermis and inflammatory reactions [37][38][39][40][41]72], as has been shown for SCLE and to some extent DLE [73][74][75][76]. Such effects still have to be verified for the other LE entities.…”

“…However, a deterioration of skin disease during the summer season can be anticipated. Diagnostic phototesting can detect such cases and should result in the recommendation of strict avoidance of UV light [37][38][39][40][41]. Anti-SS-A/Ro antibodies are found in approximately 60% of patients, mostly as anti-60 kDa Ro/SS-A.…”