Abstract

Introduction: Polymorphic light eruption is the commonest photosensitive disorder, characterized by an intermittent eruption of non-scarring erythematous papules, vesicles or plaques that develop within hours of ultraviolet radiation exposure of patient skin. Together with the lesions, a terrible itch starts and increases with the spreading of the disease, sometimes aggravated by a sort of burning sensation. The exact pathogenesis of PLE is currently unknown but findings suggest that an abnormal immune response is responsible for the tissue damage in PLE. For prophylaxis besides conventional sunscreens phototherapy is effective in many cases, when administered over several weeks.

Material and Methods: The present study was carried out in the Department of Dermatology, Sexually Transmitted Diseases and Leprosy and the Department of Biochemistry of Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh. In this study 60 clinically diagnosed polymorphic light eruption patients and 30 age, sex and BMI matched controls were included. The design of the study was interventional study comprising two Interventional groups and a control group. The patients were divided into two groups randomly and treatment was constituted accordingly.

Observation and Results: The study evaluates clinic-investigative profile and serum vitamin D levels in patients with polymorphic Light Eruption. A total of 60 symptomatic patients who served as our experimental group and 30 normal healthy individuals, post hoc matched for age, sex and demographics were recruited and evaluated.

Estimation of serum 25-hydroxy-vitamin D3 levels in PLE patients and control group showed that the mean vitamin D3 level in PLE patients (15.98 ± 7.11 ng/mL) was significantly lower (p < 0.001) than the level seen in controls (30.97 ± 6.58 ng/mL). Majority of the PLE patients had insufficient (50%) or deficient (41.7%) Vitamin D3 levels while most of the individuals in the control group had optimal vitamin D3 status (70%) representing a significant gap (p < 0.001) amongst the two groups.

Conclusions: The results of this study clearly indicate that treatment with oral vitamin D3 supplement significantly diminished the appearance and severity of PLE symptoms in the study participants. A statistically significant reduction (p < 0.001) of PLE test scores by 33.3% was observed in patients receiving oral vitamin D3 supplementation for 3 weeks along with photoprotection in the form of topical sunscreen application (5.31 ± 1.73 vs. 3.54 ± 1.78).

Keywords: Polymorphic Light Eruption; Photosensitive; Ultraviolet Radiation Exposure; 25-hydroxy-vitamin D3; Photoprotection

References

1. Rook’s Textbook of Dermatology Ed 8 29 (2010): 1-8.
2. Sharma L and Basnet A. “A clinicoepidemiological study of polymorphic light eruption”. Indian Journal of Dermatology, Venereology and Leprology 74 (2008): 15-17.
3. Norris PG., et al. “Adhesion molecule expression in polymorphic light eruption”. Journal of Investigative Dermatology4 (1992): 504-508.
4. Saeed MY., et al. “The Frequency of Some Deramatoses Related to Increase solar Radiation Exposure in Sulaimania City”. Iraqi Postgraduate Medical Journal1 (2011): 110-115.
5. Rizwan M., et al. “Photodermatoses: environmentally induced conditions with high psychological impact”. Photochemical and Photobiological Sciences1 (2013): 182-189.
6. Lehmann P and Schwarz T. “Photodermatoeses: diagnosis and treatment”. Deutsches Ärzteblatt International 9 (2011): 135-141.
7. Masahisa Watanabe., et al. “Polymorphous Light Eruption a Case Report and consideration of the Hardening Mechanism”. Dermatology 199 (1999): 158-161.
8. Lindel OF., et al. “PUVA and cancer risk: the Swedish follow-up study”. British Journal of Dermatology 141 (1999): 108-112.
9. Gruber-Wackernagel A., et al. “Frequency of occurrence of polymorphic light eruption in patients treated with photohardening and patients treated with phototherapy for other diseases”. Photodermatology, Photoimmunology and Photomedicine 2 (2019): 100-110.
10. Moncada B., et al. “Immunopathology of polymorphous light eruption. T lymphocytes in blood and skin”. Journal of the American Academy of Dermatology 6 (1984): 970-973.
11. Gibert E., et al. “Cellular immunity in polymorphous light eruption”. Medicina Cutanea Ibero 4 (1983): 253-256.
12. Hasan T., et al. “Disease associations in polymorphous light eruption. A long-term follow-up study of 94 patients”. Archives of Dermatology9 (1998): 1081-5.
13. Rossi MT., et al. “Cutaneous infiltration of plasmacytoid dendritic cells and T regulatory cells in skin lesions of polymorphic light eruption”. Journal of the European Academy of Dermatology and Venereology 6 (2018): 985-991.
14. Milliken SVI., et al. “Effects of ultraviolet light on human serum 25-hydroxyvitamin d and systemic immune function”. The Journal of Allergy and Clinical Immunology 6 (2011): 1554-1561.
15. Arnson Y., et al. “Vitamin D and autoimmunity: new aetiological and therapeutic considerations”. Annals of the Rheumatic Diseases 66 (2007): 1137-1142.
16. Gruber-Wackernagel A., et al. “Patients with polymorphic light eruption have decreased serum levels of 25-hydroxyvitamin-D3 that increase upon 311 nm UVB photohardening”. Photochemical and Photobiological Sciences 12 (2012): 1831-1836.
17. Wolf P., et al. “Rondomized double blinded placebo-controlled intra-individual trial on topical treatment with a 1,25-dihydroxyvitaminD3 analogue in polymorphiclight eruption”. British Journal of Dermatology 165 (2011): 152-161.
18. Gurber-Wackernagel A., et al. “Pathogenic mechanisms of polymorphic light eruption”. Frontiers in Bioscience (Elite Ed) 1 (2009): 341-354.
19. Wolf P., et al. “New insights into the mechanisms of polymorphic light eruption: resistance to ultraviolet radiation-induced immune suppression as an aetiological factor”. Experimental Dermatology 18 (2009): 350-356.
20. Morison WL. “Photosensitivity”. The New England Journal of Medicine 11 (2004): 1111-1117.
21. Tutrone WD., et al. Dermatologic therapy1 (2003): 28-39.
22. Berg M. “Epidemiological studies of the influence of sunlight on the skin”. Photodermatology 6 (1989): 80-84.
23. Ros A and Wennersten G. “Current aspects of polymorphous light eruptions in Sweden”. Photodermatology 3 (1986): 298-302.
24. Jansen CT. “Heredity of chronic polymorphous light eruptions”. Archives of Dermatology 114 (1978): 188-190.
25. Norris PG., et al. “The idiopathic photodermatoses: Polymorphic light eruption, actinic prurigo, and hydroa vacciniforme”. Photodermatology (1999): 103-111.
26. Van de Pas CB., et al. “An optimal method for experimental provocation of polymorphic light eruption”. Archives of Dermatology3 (2004): 286-292.
27. Dummer R., et al. “Clinical and therapeutic aspects of polymorphous light eruption”. Dermatology 1 (2003): 93-95.
28. Kontos AP., et al. “Polymorphous light eruption in African Americans: Pinpoint papular variant”. Photodermatology, Photoimmunology and Photomedicine 6 (2002): 303-306.
29. Dermatologic Disease Database. Polymorphous light eruption (2006).
30. Frain-Bell W. “The idiopathic photodermatoses”. In: Cutaneous Photobiology. Oxford University Press, Oxford (1985): 24-59.
31. Jansen CT. “The natural history of polymorphous light eruptions”. Archives of Dermatology 115 (1979): 165-169.

Citation

Citation: Anu Chandra., et al. “Correlation between Serum Vit D3 Levels and Clinicoepidemiological Profile of Polymorphic Light Eruption Patients: An Interventional Study". Acta Scientific Medical Sciences 4.11 (2020): 70-78.

Copyright

Copyright: © 2020 Anu Chandra., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.