Pinpoint papular polymorphous light eruption in Asian skin: a variant in darker‐skinned individuals

Abstract

Polymorphous light eruption (PMLE) is the most common idiopathic but probably immunologic photodermatosis and has wide morphological variants. The photobiological features of all patients diagnosed with the pinpoint papular variant of PMLE at a tertiary dermatology centre in Singapore over a five-year period were retrospectively examined. Twenty-one patients were reviewed from 2003 to 2007. There were 11 (52.4%) Chinese, four (19%) Malays, five (23.8%) Indians and one (4%) Cambodian. 14 (66.7%) were males and seven (33.3%) were females. The face/neck (48%) and arms/forearms (95%) were most often affected. Nineteen (90.5%) had Fitzpatrick skin phototype IV and two (9.5%) had skin phototype V. Six (28.6%) had decreased minimal erythema dose (MED) to ultraviolet B (UVB) light only, one (4.8%) had decreased MED to ultraviolet A (UVA) light only and one had decreased MED to both UVA and UVB. Four patients had photoprovocation test done, of which three had positive testing to UVA and one had negative testing to both UVA and UVB. Two histological subtypes were found in our patients, one showing perivascular dermatitis and the other consistent with lichen nitidus. Our data suggest that pinpoint papular PMLE is not uncommon in darker-skinned individuals in our cohort.