Polymorphic light eruption is a common phenomena. will this reaction end up leading to SLE.
how different are these two entities?
dear Venkata, polymorphic light eruption and SLE both of them are autoimmune diseases of unknown etiology responding to usual modalities for each so considered as reversible, but it is not known as PLE end up leading to SLE.
Dear Dr Satyaprasad
Early lesions of CLE may be difficult to distinguish from PMLE both clinically and histologically. Furthermore, PMLE has been reported to occur more frequently in LE patients than in the general population. Despite these associations, studies have failed to show any convincing pathophysiologic link between PMLE and LE, which suggests that the two conditions are co-morbid. An alternative explanation is that photosensitivity in LE is variable and that a PMLE-like reaction may be one of many clinical phenotypes of PS in LE.
The paper by Tzaneva etc. will be useful.
Br J Dermatol. 2008 May;158(5):1050-4. doi: 10.1111/j.1365-2133.2008.08500.x. Epub 2008 Mar 13.
Antinuclear antibodies in patients with polymorphic light eruption: a long-term follow-up study.
Tzaneva S1, Volc-Platzer B, Kittler H, Hönigsmann H, Tanew A.
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Abstract
BACKGROUND:
Previous studies have shown elevated titres of antinuclear antibodies (ANA) in 2.9-19% of patients with polymorphic light eruption (PLE). A diagnosis of lupus erythematosus (LE) was finally established in some of these ANA-positive patients.
OBJECTIVES:
To investigate whether the presence of ANA in patients with PLE merely represents an epiphenomenon or is associated with an increased risk of eventual progression to LE.
METHODS:
We identified 472 patients with PLE who had received prophylactic photo(chemo)therapy between 1986 and 2003 and were routinely tested for the presence of ANA. All ANA-positive (ANA titre of>or=1:80) patients were asked to attend for a follow-up examination comprising a medical history, complete skin inspection and a detailed laboratory analysis including ANA and antibodies against extractable nuclear antigens.
RESULTS:
Of all the patients, 55 (11.7%) were found to be ANA positive on one or several occasions, and three (0.6%) also had antibodies to SS-A/Ro. Thirty-nine (71%) of all ANA-positive patients including all Ro+ subjects were available for follow-up after a median follow-up period of 8 years (interquartile range 5-11.5). Twenty-five patients showed persistence of ANA positivity with a median titre of 1:160 (range 1:80-1:640), whereas in 14 patients ANA titres had returned to normal levels. None of the patients revealed additional clinical, histopathological or laboratory abnormalities suggestive of LE.
CONCLUSIONS:
After a median follow-up period of 8 years none of the ANA-positive patients developed LE. Our findings indicate that PLE is a benign disease without tendency to progress to LE.
Dear Dr. Venkata, I agree with the remarks of our colleagues Drs. Bashir and Jaguirdar. But I add my own point of view to your question. It is generally considered that SLE and PLE are two different diseases. However SLE clinically may show diverse clinical manifestations and sometimes looks as merely PLE; in that case it could not be easy to distinguish both conditions. If a patient diagnosed of PEL latter develops SLE, to me this is not the evolution of one to the other disease but a case of SLE that initially seemed PLE. In Medicine it is easier to confirm that someone has a disease when diagnosis is evident, than to say he has not it. For that reason when establishing a medical certificate of health we usually write that the patient is “apparently” in good conditions unlike when he/she has a definite disease that could be clearly stated in the certificate.
Dear Dr Venkata :
to my knowledge SLE is just one of the differential diagnoses of PLE , although in some cases it will not be easy to confirm one or the other .
i completeley agree Dr Mascaró answer. Many times it is difficult initially to make the differential diagnosis between this two entities, bit although both are inmunologicaly mediated, they are different entities
Dear Venkata Polymorphic light eruption (PLE) is a common intermittent sunlight or artificial UVR-induced eruption, particularly of temperate regions, affecting subjects
of any race within hours or rarely days of exposure. The rash is non-scarring, itchy, erythematous and usually papular, although it is sometimes plaque-like, vesicular,
bullous or mixed. It usually affects exposed skin, but may occur on covered areas, and lasts for days to a week or two after exposure has ceased. It is most common in young women, is often worse in spring, and is probably a delayed-type hypersensitivity reaction against endogenous cutaneous photoantigen as a result of a genetically
determined reduction in UVR-induced cutaneous immunosuppression.
PLE is different from lupus erythematosus (LE), which may also precede or coexist with PLE by its characteristic circulating and cutaneous immunological abnormalities.
Dear coleague
PLE never change to LE, the former is only cutaneous. And LE is a systemic disease, whith cutaneous lesions that are diferent them PLE.
It´s not usually expected the coexistence of this diseases.
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