Onset Of Photosensitivity Research Articles

Emergence of Photosensitivity with Decreased Treg Cells in a Patient with Mycosis Fungoides Treated with Anti-CC Chemokine Receptor 4 Antibody Mogamulizumab

Mogamulizumab is a therapeutic monoclonal antibody that targets the CC chemokine receptor 4 (CCR4). The treatment exhibits strong cytotoxicity for adult T-cell leukaemia/lymphoma (ATLL) cells via antibody-dependent cellular cytotoxicity (ADCC), although it carries the risk of serious adverse reactions to the skin, such as StevensJohnson syndrome (1, 2). We report here a patient with mycosis fungoides (MF) at tumour stage treated with mogamulizumab, who developed a photosensitivity reaction during the course of treatment. At the onset of photosensitivity, a reduction in both circulating and skin infiltrating regulatory T cells (Tregs) was observed.

Photosensitive atopic dermatitis--a neglected subset: Clinical, laboratory, histological and photobiological workup.

Photosensitive atopic dermatitis (PhAD) is a scarcely reported entity characterized clinically by a photodistributed rash in patients who fulfil the criteria for atopic dermatitis (AD). The aim of this retrospective study is to define significant clinical, laboratory and immunological parameters as well as photobiological features for diagnosing PhAD. We conducted a single-centre retrospective analysis of 17 patients with long-standing AD who in the disease course suddenly developed photosensitivity. All patients with suspected PhAD treated in our department between 2009 and 2014 were included in the study. Diagnostic methods were immunological parameters, prick and patch testing, histology and phototesting procedures. Onset of photosensitivity was observed during spring, summer and during exposure to artificial UVR (Ultraviolet radiation) as part of the patients' treatment regimen. Symptoms appeared 31.5 months on average after AD diagnosis was established. Although the MED (Minimal erythematous dose) was normal compared to a control group, all patients tested with photoprovocation methods exhibited a positive reaction. Two types of reactions were observed: papular and eczematous reactions, both types having similar histology. The wavelength spectrum most commonly involved was UVA. The disease seems to affect women more often than men. Predilection sites included face, neck, exposed trunk areas and arms. Patients with PhAD had coexistent eczematous lesions in non-sun-exposed skin. IgE levels were elevated in 11/17 patients (65%), with a median value of 269 kU/L. PhAD is an underreported subset of atopic dermatitis, which is rarely diagnosed. This study suggests that several features including atopic diathesis, eczematous lesions in UVR exposed body regions and positive photoprovocation reaction are suggestive of PhAD as the likely diagnosis. Typically, the atopic eczema starts without a sign of photosensitivity, however, in a subgroup of AD patients after a few months to years, a switch occurs leading to PhAD.

Photoaggravated hand and foot psoriasis

The majority of patients with psoriasis benefit from ultraviolet radiation exposure, but psoriasis can deteriorate on exposure to sunlight in some people. We report a patient with longstanding palmoplantar psoriasis that showed an unusual evolution into photoaggravated psoriasis, with change of distribution from the palmar to the dorsal aspect of the hands, and confirmation by photoprovocation with solar-simulated radiation. The onset of photosensitivity should be suspected in patients with hand and foot psoriasis showing a similar change in distribution.

Actinic prurigo: Clinical features and HLA associations in a Canadian Inuit population

Background: Actinic prurigo (AP) is an idiopathic familial photodermatitis. AP of the Inuit is rarely reported and poorly characterized. Objective: Our purpose was to examine the clinical features and HLA associations of AP in an Inuit population. Methods: Thirty-seven Inuit subjects with AP were administered a questionnaire and underwent a cutaneous examination. Other causes of photosensitivity were excluded. HLA class I typing was performed by polymerase chain reaction and sequence-specific primers and class II typing by polymerase chain reaction and sequence-specific oligonucleotide probes. Results: Subjects were 81.1% female, 67.6% had a family history of photosensitivity, and all experienced seasonal variation. The average age at onset of photosensitivity was 29 years, and only 27% had a trend toward improvement in photosensitivity. Involvement of eyes and nonexposed skin was reported in 62.2% and 18.9% of subjects, respectively. Physical examination revealed involvement of the face (64.9%), lip (32.4%), ear (13.5%), and dorsal aspect of the hand (24.3%). HLA-DRB1*14 was present in 51.2% of subjects and 26.2% of controls (P = .022, odds ratio = 2.975). This is a previously unreported HLA association. Conclusion: AP in the Inuit is a seasonal, pruritic photodermatitis, often commencing in adulthood and worsening over time. A novel association with HLA-DRB1*14 has been discovered. Overall, this novel HLA association, the absence of HLA associations previously reported in non-Inuit populations, and clinical distinguishing features support the concept that AP in the Inuit may have a distinct immunopathogenic basis that translates into a different phenotype. It also raises the question of whether AP in the Inuit is a distinct photosensitivity disorder specific to this group that has been genetically isolated because of geographic and cultural seclusion. (J Am Acad Dermatol 2001;44:952-6.)

The Timing of Gonadal Refractoriness in the Female Turkish Hamster (Mesocricetus Brandti) is not Dependent on the Timing of Gonadal Regression1

When prepubertal female Turkish hamsters are reared on 12L:12D, individuals respond reproductively in two ways; the majority exhibit a delay in the onset of regular vaginal estrous cyclicity (first vaginal estrus; FVE), and some individuals exhibit FVE at a time not different from females reared on 16L:8D. Soon, however, these females also become reproductively quiescent. This study addresses the following questions: (1) At what age do these two subpopulations become refractory to 12L:12D? (2) Is the onset of refractoriness in adults reared on 12L:12D dependent on the time when they become anovulatory? All females reared on 12L:12D become refractory at a similar age (169.1 +/- 4.4 days in those that exhibit delayed FVE vs. 165.3 +/- 6.8 days in those that exhibited an early FVE and then became anovulatory; p much greater than 0.05). Also, there is no correlation between the age at which vaginal cycles ceased and the age at which those individuals became refractory (r2 = 0.12; slope not different from 0). On the basis of these data, we propose that in the female Turkish hamster the onset of photorefractoriness is timed, not by the interval of reproductive quiescence, but by a preceding event, perhaps the initiation of short photoperiod exposure or the onset of photosensitivity.

Hepatoerythropoietic Porphyria

In a case of hepatoerythropoietic porphyria (HEP) with unusual features, the patient had onset of photosensitivity in infancy, followed by spontaneous resolution of photosensitivity by the age of 7 years. Seven other cases of HEP have been found in the medical literature; the disease has systemic complications, mainly liver disease and anemia, and is inherited as an autosomal recessive trait. Certain clinical and biochemical features distinguish HEP from erythropoietic porphyria and erythropoietic protoporphyria, the two diseases with which HEP is often confused.