Abstract
Background: Little is known about the long-term course of polymorphic light eruption (PLE).Objective: To predict disease course, a questionnaire was sent to patients whose PLE had been diagnosed between March 1990 and December 2018 and documented in the Austrian Cooperative Registry for Photodermatoses.Methods: In January 2019, 205 PLE patients were contacted by mail and asked to complete a questionnaire on their disease course, including whether the skin's sun sensitivity had normalized (i.e., PLE symptoms had disappeared), improved, stayed the same, or worsened over time. Patients who reported normalization of sun sensitivity were asked to report when it had occurred.Results: Ninety-seven patients (79 females, 18 males) returned a completed questionnaire. The mean (range) duration of follow-up from PLE onset was 29.6 (17–54) years for females and 29.4 (16–47) years for males. The disease disappeared in 32 (41%) females after 17.4 (2–41) years and in 4 (24%) males after 11.8 (5–26) years. Twenty-nine (37%) females and 6 (35%) males reported improvement of symptoms over time; 15 females (19%) and 7 males (41%) reported no change; and 3 females (4%) and no males reported worsening of symptoms. Kaplan-Meier analysis revealed that after 20 years 74% (95%CI, 64–82%) of patients still suffered from PLE. PLE lesion persistence (>1 week) tended to predict a prolonged course of PLE.Conclusions: PLE usually takes a long-term course over many years though in most patients its symptoms improve or disappear over time. How improvement relates to the pathophysiology of the disease remains to be determined.
Highlights
Polymorphic light eruption (PLE) is the most common and prevalent photodermatosis, among young women in temperate climates [1,2,3,4]
Many individuals experience a hardening effect after repeated exposure [2, 7, 8], making skin lesions less likely to occur or less severe. This natural photohardening effect as well as the hardening effect of prophylactic medical phototherapy are lost in winter; PLE lesions recur the year and often for years to come [2, 9, 10]
The most common morphological type of PLE was macular in females (63%) and papular in males (60%), with overlap among the other different morphological types in many patients (Table 1)
Summary
Polymorphic light eruption (PLE) is the most common and prevalent photodermatosis, among young women in temperate climates [1,2,3,4]. Many individuals experience a hardening effect after repeated exposure [2, 7, 8], making skin lesions less likely to occur or less severe. Methods: In January 2019, 205 PLE patients were contacted by mail and asked to complete a questionnaire on their disease course, including whether the skin’s sun sensitivity had normalized (i.e., PLE symptoms had disappeared), improved, stayed the same, or worsened over time. Conclusions: PLE usually takes a long-term course over many years though in most patients its symptoms improve or disappear over time. How improvement relates to the pathophysiology of the disease remains to be determined
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