What are the other Names for this Condition? (Also known as/Synonyms)

• PLE (Polymorphic or Polymorphous Light Eruption)
• PMLE (Polymorphic or Polymorphous Light Eruption)
• Polymorphic Light Eruption

What is Polymorphous Light Eruption? (Definition/Background Information)

• Polymorphous Light Eruption (PLE or PMLE) is a very common photosensitivity reaction that is caused due to sunlight exposure. These are of 2 types:
  • Juvenile Spring Polymorphous Light Eruption: It commonly occurs in young boys; the skin on the ears are typically affected
  • Benign Summer Polymorphous Light Eruption: Mostly young women are affected; there is the presence of itching and red erythematous skin after getting exposed to sunlight
• Polymorphous Light Eruption is caused by a reaction of the skin to sunlight resulting in the characteristic signs and symptoms, such as red skin and formation of blisters, on the sun-exposed areas. In severe cases, body pain and other symptoms may be felt
• Polymorphous Light Eruption is treatable using topical creams and steroids, or medications and intravenous fluids for systemic condition. However, recurrence of the condition is observed
• The prognosis of PLE with adequate treatment is excellent in most cases

Who gets Polymorphous Light Eruption? (Age and Sex Distribution)

• Polymorphous Light Eruption is mostly observed in individuals who are less than 30 years of age. After this period, the chances of PLE are very low
• Females are typically affected much more than males
• There is no racial or ethnic preference observed. However, fair-skinned individuals (such as Caucasians) are more prone to the condition than dark-skinned individuals (such as Africans or Asians)

What are the Risk Factors for Polymorphous Light Eruption? (Predisposing Factors)

The risk factors for Polymorphous Light Eruption include:

• Family history of PLE
• Exposure to intense sun for long periods during the course of work, or due to participation in outdoor sports and other activities
• Those who work outdoors when sun intensity is at its highest; the sun is a big source of ultraviolet light and the highest exposure occurs around noon
• Visiting tropical regions for the first time (especially from non-tropical areas)
• Those with sensitive skin, who get easily sunburned
• Fairer-skinned individuals have a greater risk than darker-toned individuals
• Individuals with weak immune system, which could be due to cancer treatment, AIDS, or those on immunosuppressant drugs after receiving an organ transplant

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Polymorphous Light Eruption? (Etiology)

• The cause of Polymorphous Light Eruption is generally unknown, but it occurs on exposure to sunlight
• Some researchers believe that it is a type 4 delayed hypersensitivity reaction to sunlight

What are the Signs and Symptoms of Polymorphous Light Eruption?

The signs and symptoms of Polymorphous Light Eruption (PLE) may include the following features:

• The common symptom include skin itchiness after being exposed to sunlight; it usually occurs on the sun-exposed areas of the body
• Red color skin rashes
• The skin lesions may be confused with hives; the skin lesions can be macules or papules or vesicles, but usually a combination of macules, papules, or vesicles do not occur
• In time, the condition can lead to blister formation
• In severe cases, body pain, fatigue, fever and chills may be observed
• The affected regions typically include, body areas exposed to the sun, such as the face, neck, bald portion of the scalp, hands, and even the chest
• The signs and symptoms can last for up to a week
• In young women with Benign Summer PLE, the symptoms can recur each year

How is Polymorphous Light Eruption Diagnosed?

A diagnosis of Polymorphous Light Eruption is made by:

• Physical examination of the skin (lesion) and medical history evaluation (including history of any recent travel). This is usually sufficient to arrive at a diagnosis; although in rare cases, a biopsy may be performed
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Polymorphous Light Eruption?

The possible complications due to Polymorphous Light Eruption (PLE) may include:

• Discomfort, irritability of the affected skin
• Secondary or superimposed infections due to bacteria or fungus, particularly if the blisters are picked or scratched
• The affected areas can heal with either increased or decreased pigmentation
• The condition can become recurrent and chronic resulting in longstanding PLE

How is Polymorphous Light Eruption Treated?

The treatment measures available for Polymorphous Light Eruption may include:

• Moving away from hot locations; cooling the affected area with cold running water (and not with ice)
• Hydration with appropriate fluids containing electrolytes
• Topical treatment includes cooling the skin using moist towels and moisturizing creams to soothe the condition
  • Use of topical ointments, lotions, and creams - these may be antiseptic and anti-inflammatory applications
  • Creams containing aloe vera and soy should be considered
  • Creams containing petroleum products should be generally avoided, since it can worsen the condition in some individuals
• Systemic therapy using medications, such as beta carotene, can help in some cases
• In severe cases, treatment using medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, to reduce signs and symptoms
• Even though sunscreens are not very effective, they should be tried as a treatment measure, since it can help some individuals
• Treatment in spring: Photochemotherapy using ultraviolet A (UVA) light in a controlled fashion can help decrease the intensity of the signs and symptoms

How can Polymorphous Light Eruption be Prevented?

A few methods to prevent Polymorphous Light Eruption (PLE) include:

• Avoid prolonged and chronic exposure to the sun
• Take adequate safety steps to reduce exposure to the UV rays, by using sunscreens with high sun-protection factor, wide-brimmed hats, and protective clothing
• During summer, adequate sun-exposure and oral steroids, a few days before vacationing in the tropical areas can help prevent the development of PLE
• Phototherapy using narrowband UVB light can be used as preventative measure, incrementally building up the tolerance of the skin to light
• Avoid excessive sunbathing (particularly if you are fair-skinned), use of tanning beds, sun lamps, and chemical agents, that accelerate sun tanning
• Individuals who are regularly exposed to the sun, or work under the sun should get their skin periodically examined by a physician. This is crucial if they suspect, or if there are any noticeable skin changes
• Keep yourself well-hydrated, if sun-exposure for prolonged periods is unavoidable

What is the Prognosis of Polymorphous Light Eruption? (Outcomes/Resolutions)

• The prognosis of Polymorphous Light Eruption (PLE) is excellent with appropriate treatment in a majority of cases
• In some individuals, the severity of the signs and symptoms may decrease over time without treatment, and sometimes altogether disappear
• However, PLE can recur on exposure to ultraviolet radiation again and become a chronic condition

Additional and Relevant Useful Information for Polymorphous Light Eruption:

Do not pick or pop the blisters, for doing so can affect the healing process and may result in secondary infections.