What are the physical findings of variants of polymorphous light eruption (PMLE)?

Updated: Jan 22, 2020
  • Author: Saud A Alobaida, MBBS, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Answer

Other variants of PMLE include a pinpoint papular variant observed in African Americans, benign summer light eruption (BSLE), solar purpura, juvenile spring eruption (JSE), localized PMLE, scar PMLE, and PMLE sine eruption.

The pinpoint variant seems to be observed in patients with Fitzpatrick skin types IV-VI. [30] African Americans present with pinpoint papules (1-2 mm) that can be observed on sun-exposed areas, sparing the face and flexural surfaces. [37] It has also been described in a series from Singapore [38] and in a series of 34 Taiwanese patients whose rash resolved with sun protection. [29] Ten of these Taiwanese patients had mild spongiosis on biopsy.

BSLE presents with a mild form.

JSE presents in children, with papules or papulovesicles that can erode and typically involve the helices of the ears. JSE is more common in boys than in girls, likely because girls traditionally have longer hair that protects their ears from sunlight exposure.

PMLE sin eruption presents with no visible lesions but symptoms of pain or pruritus upon exposure to UV light.

In a retrospective study from Spain in 2013, [39] 5 men and 4 women were suggested to have a localized variant of PMLE, termed ”spring and summer eruption of the elbows" by the authors. The mechanism that confined the lesions to these specific areas was not determined.

Scar PMLE that can occur on hypopigmented scars has been noted in India. [40]


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