Insight into immunocytes infiltrations in polymorphous light eruption.

Polymorphous light eruption (PLE) which is one of the most common photodermatoses has been demonstrated to be immune-mediated disorder. Resistance to UV-induced immunosuppression resulting from differential immune cells infiltration and cytokines secretion has been highlighted in the pathogenesis of PLE. In this study, we reviewed differential patterns of immune cells infiltrations and cytokines secretion that may contribute to PLE occurrence and development.

Effect of hair color and sun sensitivity on nevus counts in white children in Colorado.

BACKGROUND: It has been widely reported that individuals with a light phenotype (ie, light hair color, light base skin color, and propensity to burn) have more nevi and are at greater risk for developing skin cancer. No studies have systematically investigated how phenotypic traits may interact in relation to nevus development. OBJECTIVE: We sought to systematically examine whether any combinations of phenotype are associated with a greater or lesser risk for nevus development in white children. METHODS: In the summer of 2007, 654 children were examined to determine full body nevus counts, skin color by colorimetry, and hair and eye color by comparison with charts. Interviews of parents were conducted to capture sun sensitivity, sun exposure, and sun protection practices. RESULTS: Among 9-year-old children with sun sensitivity rating type II (painful burn/light tan), those with light hair had lower nevus counts than did those with dark hair (P value for interaction = .03). This relationship was independent of eye color, presence of freckling, sex, usual daily sun exposure, sunburn in 2004 to 2007, sun protection index, and waterside vacation sun exposure. The difference in nevus counts was further determined to be specific to small nevi (<2 mm) and nevi in intermittently exposed body sites. LIMITATIONS: Geographic and genetic differences in other study populations may produce different results. CONCLUSION: The standard acceptance that dark phenotype is a marker for low melanoma risk and light phenotype a marker for high risk may need to be reevaluated. In non-Hispanic white children, dark-haired individuals who burn readily and then tan slightly are more prone to nevus development, and may therefore be a previously underrecognized high-risk group for melanoma.

[Photodermatoses during childhood]. / Lichtdermatosen im Kindesalter.

Actinic dermatitis and phototoxic and idiopathic photodermatoses occur relatively often during childhood. Photodermatoses stemming from enzyme defects and genetic disorders are much less common, while photoallergic and chronic actinic dermatitis have not been dealt with to date. A specific sensitivity of a child's skin to light is often the first manifest clinical symptom of a photodermatosis, the key is to ensure early diagnosis. However, it is often difficult to reach a diagnosis, as the lesions are barely perceptible or have even healed by the time the patient is examined. This is why photoprovocation tests are so important in diagnosing photodermatoses, particularly during childhood. In addition to early diagnosis of these illnesses and offering the appropriate treatment, it is also crucial that the parents be well informed and aware of what symptoms to look for so that they can protect their children from overexposure to UV light and thereby avoid later actinic injuries that can become as serious as malignancies.

Polymorphous light eruption in African Americans: pinpoint papular variant.

BACKGROUND: Polymorphous light eruption (PMLE) is the most common chronic idiopathic photodermatosis usually manifesting as a papular eruption (3-6 mm), with several other morphological variants described. METHODS: Between June 1998 and August 2001, nine patients presented with complaints of a pruritic pinpoint papular eruption associated with sun exposure. A detailed history and complete skin examination were performed along with a skin biopsy if active lesions were present. Phototesting to ultraviolet-A (UV-A), ultraviolet-B (UV-B) and visible light was performed in four patients. Antinuclear antibody (ANA) testing was performed in three patients. The diagnosis of PMLE was made based on the history, morphology of the lesions, results of phototesting and skin biopsy if available. RESULTS: In all patients, pinpoint papules (1-2 mm) were observed on sun-exposed areas, sparring the face and flexural surfaces. All patients were African American women with skin type IV-VI and a mean age of 39.3 years (range 21-52 years). Phototest results were normal in three patients; one patient, who was on glyburide, had a decreased minimal erythema dose to UV-A. ANA testing was negative. Two histopathologic patterns were observed: (i) focal lichenoid and perivascular lymphohistiocytic infiltrate with red blood cell extravasation in four specimens and (ii) superficial and deep interstitial lymphocytic infiltrate with papillary dermal edema in the remaining three specimens. All patients responded to topical corticosteroids, broad-spectrum sunscreens and antihistamines. CONCLUSION: Recognition of this pinpoint papular variant of PMLE in dark-skinned individuals is important in the evaluation and management of these patients.

[Actinic prurigo. An assessment of current status]. / Aktinische Prurigo. Eine Standortbestimmung.

BACKGROUND AND OBJECTIVE: Actinic prurigo (AP) is a hereditary photodermatoses with typical symptoms and is quite common in North- and South-America. The key genetic factor appears to be a Native American background. In Europeans this type of AP is extremely rare; some dispute if this disease exists in Caucasians. Some newer publications postulate that these patients share HLA markers with the Native Americans. The most important differential diagnosis for AP is polymorphic light eruption which can be excluded relatively accurately by the clinical picture, typical histology and HLA pattern. PATIENTS/METHODS: The case of a female patient of Mayan ancestry living in Germany is presented. CONCLUSIONS: Since in literature sometimes cases from Europe are diagnosed as AP this is a problem of naming the disease. It would be helpful to integrate the terms hereditary or hereditaria into the name of the disease in indians.

Relationship between constitutive skin color and ultraviolet light sensitivity in Koreans.

The assessment of skin sensitivity to ultraviolet (UV) radiation is important in treating a variety of skin diseases and preventing the deleterious effects of UV. Although there are many ways to predict the sensitivity to UVR, controversies exist over their objectivity, correlation, and applicability in various races. For the purpose of evaluating the relationship of skin color and UV responsiveness, this study was performed to assess the validity of constitutive skin color for an individual's UV sensitivity in 80 healthy Korean volunteers. The subjects were divided into two groups: a young-aged group with 40 subjects aged 20-39 years and an old-aged group with 40 subjects aged 43-63 years. A minimal erythema dose (MED) of UVB and minimal immediate pigment darkening dose (MIPDD) of UVA were assessed using a fluorescent lamp (Panasol II, National Biologic Co., Twinberg, USA) and a metal-halide lamp (Dermalight 2001, Mutzhas, Munich, Germany), respectively. The constitutive skin color of buttock was measured with a Minolta Chroma Meter CR-300 (Osaka, Japan), using the CIE (Commission International de l'Eclairege) L*a*b* system. Of the three L*a*b*, we used the L* value to estimate the skin color. For the MED and L* values, the values were inversely proportionate (P<0.05) in the young-aged group; however, no correlation existed in the old-aged group. No relationships existed among Fitzpatrick skin type and MED, skin type and MIPDD. The results of this study indicated that the constitutive skin colors in the young-aged group can be an objective and adequate predictor of cutaneous UV sensitivity.

[Actinic prurigo of childhood. 3 familial cases associated with HLA-DR 0407]. / Prurigo actinique de l'enfant. 3 cas dans une fratrie avec association au HLA-DR 0407.

BACKGROUND: Actinic prurigo, as idiopathic skin reaction involving light-exposed areas, was first described in American Indians. Actinic prurigo was early considered to be a particular form at polymorphous phototoxicity, but can be identified as a specific entity on the bases of clinical features and epidemiological characteristics. CASE REPORTS: Three children in the same family developed photosensitive reactions early in childhood with characteristic polymorphous and persistent eczema-like or papulo-nodular pruriginous lesions which predominated in light-exposed areas and appeared several hours after exposure to sun. The lesions persisted during the winter season. The lesions followed a chronic course but tended to improve at puberty. Clinical laboratory tests, serum and urine porphyrin levels and antinuclear factors were normal. Histology and photobiology explorations gave non-specific results. DISCUSSION: These observations have three points in common with actinic prurigo observed in American Indians. HLA typing showed that our three patients, as in white patients in Great Britain, had a significant association with a specific HLA DR1 subtype: DRB1*0407. This DRB1*0407 alleles could play a role in initiating the immune response to a light-induced peptide antigen. This particular genetic predisposition, if confirmed in other studies, would be an additional argument for distinguishing actinic prurigo as a specific polymorphous phototoxicity entity.