What is the role of vitamin therapy in the treatment 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

Some authorities believe that vitamin therapy is helpful in the treatment of PMLE. Nicotinamide was successful in 60% of 42 patients treated with 3 g/d orally for 2 weeks. [54] The rationale for its use was the knowledge that it blocks the formation of kynurenic acid, a photosensitizer that may play a role in PMLE. Ahmed et al found that oral vitamin E supplementation (400 IU) and use of sunblock decreased the markers of oxidative stress and lipid peroxidation in patients with PMLE. [53]

Systemic vitamin C and vitamin E do not prevent photoprovocation test reactions in persons with PMLE. [55]

The effect of topical calcipotriol (an analog of calcitriol, 1,25-dihydroxyvitamin D3) was described by Gruber-Wackernagle et al. [56] They evaluated the preventive effect of topical calcipotriol in a randomized, double-blinded, placebo-controlled, intraindividual half-body trial. Thirteen patients with PMLE applied cream (calcipotriol or placebo) topically to symmetrically located pairs of test areas twice daily for 7 days before photoprovocation with solar-simulated UV radiation was begun. The authors used a specific PMLE test score based on affected area, skin infiltration, and pruritus to rate symptom severity at 48, 72, and 144 hours after the first photoprovocation exposure. They found pretreatment with calcipotriol, compared with placebo, significantly reduced PMLE symptoms on average by 32% (P = .0022), suggesting a possible benefit from prophylactic use of topical 1,25-dihydroxyvitamin D3 analogs in patients with PMLE.


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