Photosensitivity in lupus erythematosus, UV photoprovocation results compared with history of photosensitivity and clinical findings

Hasan, Taina; Nyberg, Filippa; Stephansson, Eija; Puska, Päivi; HÄKKINEN, M.; Sarna, S; Ros, Anne‐Marie; Ranki, Annamari

doi:10.1046/j.1365-2133.1997.6591644.x

Cited by 58 publications

(75 citation statements)

References 30 publications

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“…The patients underwent irradiation using approximately 2 minimal erythema doses of UV-A and UV-B on 3 consecutive days on 2 separate intact skin areas, as described previously. 15 A biopsy specimen was obtained from the UVirradiated skin sites for routine histological investigation.…”

Section: Clinical Laboratory and Photobiological Investigationmentioning

confidence: 99%

Disease Associations in Polymorphous Light Eruption

Hasan¹,

Ranki²,

Jansén³

et al. 1998

Arch Dermatol

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To examine the long-term outcome of polymorphous light eruption (PLE) in a large patient population and to evaluate associated conditions, especially lupus erythematosus, during the course of the disease.Design: A questionnaire-based follow-up study an average of 32 years after onset of PLE. The study was complemented by clinical examination of the patients with PLE similarly studied 16 years earlier or now reporting equal or worse PLE symptoms compared with the 1978-1979 followup or any symptoms suggesting an autoimmune disease.Setting: A dermatologic clinic in a university hospital.Patients: Ninety-four of the original cohort of 138 patients with PLE (87% of living patients) returned the questionnaire, and 46 (84%) of the 55 patients invited volunteered for clinical examination.Intervention: None.Main Outcome Measures: Clinical characteristics of PLE and clinical and laboratory findings referring to associated diseases, especially lupus erythematosus.Results: Twenty-three (24%; 95% confidence interval [CI], 16%-34%) of the 94 patients were cured, 48 (51%; 95% CI, 41%-62%) experienced milder symptoms, and 23 (24%; 95% CI, 16%-34%) experienced equal or worse symptoms than in the 1978-1979 follow-up. At least 1 autoimmune disease was diagnosed at some point in 14 patients (15%; 95% CI, 12%-29%) (in 13 [18%] of the female patients) and lupus erythematosus specifically in 2 (2%; 95% CI, 0%-7%) (in 2 [3%] of the female patients). The prevalence of a thyroid disease was 14% (13 patients) (95% CI, 8%-23%). Conclusion:Polymorphous light eruption is a longstanding, slowly ameliorating disease with some tendency to development of autoimmune disease or thyroid disorder, especially in female patients, but the risk for lupus erythematosus is not increased.

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Section: Clinical Laboratory and Photobiological Investigationmentioning

confidence: 99%

Disease Associations in Polymorphous Light Eruption

Hasan¹,

Ranki²,

Jansén³

et al. 1998

Arch Dermatol

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“…In addition, CLE patients may not be aware of their photosensitivity because lesion formation appears with a latency of up to 3 weeks after exposure to UV irradiation (4,19). Moreover, photosensitivity may be overreported by patient history due to the inability of patients to distinguish CLE from other photodermatoses, such as PLE, which appears more frequently in CLE patients than in the normal population (28,29). Therefore, the patients' variable knowledge of the disease characteristics may explain some of the reported differences in the frequency of photosensitivity.…”

Section: Discussionmentioning

confidence: 99%

Updated Analysis of Standardized Photoprovocation in Patients With Cutaneous Lupus Erythematosus

Ruland

Haust

Stilling

et al. 2013

Arthritis Care & Research

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Objective. To determine the frequency and reproducibility of standardized photoprovocation in patients with cutaneous lupus erythematosus (CLE) and report our long-term experience. Methods. Photoprovocation using a standardized protocol was evaluated retrospectively in 566 patients. A diagnosis of CLE was clinically and/or histologically confirmed in 431 patients, and 315 patients with polymorphic light eruption (PLE) were additionally included as controls. Data were statistically analyzed using an SPSS database. Results. A total of 61.7% of the 431 CLE patients exhibited a positive photoprovocation, with a significantly longer latency period for the development of skin lesions after ultraviolet (UV) A and/or UVB irradiation than PLE patients (P < 0.001). The frequency of positive photoprovocation varied among the CLE subtypes, and intermittent CLE was the most photosensitive disease entity (74.8%). Subsequent photoprovocation in 35 patients demonstrated that CLE patients with an initial positive result exhibited a significantly higher frequency of a positive photoprovocation at a later time point (P ‫؍‬ 0.013). However, an initial positive photoprovocation did not definitively predict a positive reaction at a later time point. Moreover, patient history of photosensitivity was not a predictor for the photoprovocation outcome. Conclusion. Standardized photoprovocation is a useful tool to reproducibly induce skin lesions and objectively evaluate photosensitivity in patients with CLE. These data further suggest that the reaction to UV light may change during the course of this heterogeneous disease and that photosensitivity should not be excluded in patients with a negative history of photosensitivity.

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“…No signs of photosensitivity occurred in any of our patients. Symptoms of photosensitivity are reported to occur in patients with SLE when irradiated with UVA doses higher than 20 J/cm 2 ,8 and thus a UVA-1 dose higher than 6 J/cm 2 might result in a better outcome. Also, it is not known how long the clinical effect of UVA-1 in patients with SLE lasts once the treatment is stopped.…”

Section: Discussionmentioning

confidence: 99%

“…After exposure to sunlight patients show persistent erythema, erythematous papules, or papulovesicles. Mainly UVB and, to a lesser extend UVA, are held responsible for the signs of photosensitivity occurring 8. Accordingly, the first reports on the beneficial effects of long wave UVA-1 in patients with SLE were unexpected.…”

mentioning

confidence: 99%

UVA-1 cold light treatment of SLE: a double blind, placebo controlled crossover trial

Polderman

Huizinga²,

Cessie³

et al. 2001

Annals of the Rheumatic Diseases

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Objective-Treatment of patients with systemic lupus erythematosus (SLE) often implies strong drugs with possibly serious side eVects. Thus there is a need for new immunosuppressive treatments. Long wave ultraviolet A (UVA-1) cold light therapy is an anti-inflammatory, immunomodulatory treatment with a possible systemic eVect and few side eVects. In the current study low dose UVA-1 cold light treatment was tested to determine whether it reduces disease activity in SLE. Methods-Eleven patients with SLE were treated with UVA-1 cold light treatment and a placebo light treatment in a double blind, placebo controlled, crossover study. In two consecutive 12 week periods the patients were treated in the first three weeks with UVA-1 and placebo treatment or vice versa. The primary variables were the SLE Disease Activity Index (SLEDAI) and SLE Activity Measure (SLAM). Results-The mean SLAM and SLEDAI showed a significant decrease of 30.4% (p=0.0005) and 37.9% (p=0.016) respectively after three weeks of UVA-1 and a non-significant decline of 9.3% (p=0.43) and 12.2% (p=0.54) respectively after three weeks of placebo treatment. In this small trial the diVerence in reduction of the disease activity indices during UVA-1 compared with during placebo treatment failed to reach the conventional border of significance (p=0.07). The total score of quality of life measure RAND-36 did not improve significantly, but the subscore for vitality did improve. Conclusion-Low dose UVA-1 cold light treatment was strongly suggestive of lowering disease activity in this double blind placebo controlled study, and no side eVects occurred.

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Photosensitivity in lupus erythematosus, UV photoprovocation results compared with history of photosensitivity and clinical findings

Cited by 58 publications

References 30 publications

Disease Associations in Polymorphous Light Eruption

Disease Associations in Polymorphous Light Eruption

Updated Analysis of Standardized Photoprovocation in Patients With Cutaneous Lupus Erythematosus

UVA-1 cold light treatment of SLE: a double blind, placebo controlled crossover trial

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