Cited by 21Skin Protection and Agingmelanin and skin pigmentationContact Dermatitis and Allergies

Prevention of polymorphic light eruption with a sunscreen of very high protection level against UVB and UVA radiation under standardized photodiagnostic conditions

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Schleye, Verena, Weber, Oliver, Yazdi, Amir, Benedix, Frauke, Dietz, Klaus, Röcken, Martin, Berneburg, Mark·2008·Acta Dermato-Venereologica

Abstract

Polymorphic light eruption (PLE), with an overall prevalence of 10-20%, is mainly provoked by ultraviolet A (UVA) (320-400 nm) and to a lesser degree by UVB (280-320 nm). The most effective prophylaxis of PLE, application of UV protection clothing, is not feasible for all sun-exposed areas of the skin and UV-hardening is time-consuming and may be associated with side-effects. Most sunscreens protect predominantly against UVB and therefore fail to prevent PLE. The protection level of potent UVA-protective filters remains unresolved. This single-centre, open, placebo-controlled, intra-individual, comparative study, analysed the efficacy of a sunscreen of very high protection level against UVB and UVA, containing methylene bis-benzotriazolyl tetramethylbutylphenol (Tinosorb M), bis-ethylhexyloxyphenol methoxyphenyl triazine (Tinosorb S) and butyl methoxydibenzoylmethane as UVA absorbing filters, in the prevention of PLE under standardized photodiagnostic conditions. After determination of the minimal erythema dose at day 0, photoprovocation was performed in 12 patients with a clinical history of PLE, on days 1, 2 and 3 with 100 J/cm2 UVA and variable doses of UVB, starting with the 1.5-fold minimal erythema dose of UVB. Prior to irradiation, placebo was applied to the right and sunscreen to the left dorsal forearm under COLIPA (European Cosmetic, Toiletry and Perfumery Association) conditions. In 10 patients PLE could be provoked at the placebo site, with positive reactions in 90% of the UVA, 40% of the UVB and 90% of the UVA/UVB irradiated fields. At the site with the active treatment none of these patients developed PLE. These data demonstrate that a sunscreen with effective filters against UVA and UVB can successfully prevent the development of PLE. Further studies are needed to examine whether regular application of sunscreen under everyday conditions, especially in doses less than the tested COLIPA-norm, could be an equivalent alternative to UV-hardening therapy.

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  • It is recommended that patients with polymorphic light eruption use broad spectrum sunscreens to reduce the frequency of flares.

    “For example, it is recommended that patients with polymorphic light eruption use broad spectrum sunscreens to reduce the frequency of flares (52).”

    From Photoprotection: a Review of the Current and Future Technologies (2010) · cites this paper as [52]

    The Abstract and Discussion report that a sunscreen with very high UVA and UVB protection prevented PLE lesions during standardized photoprovocation. They do not establish that broad-spectrum sunscreens generally reduce the frequency of flares in everyday use; the Discussion says further studies under daily sun-exposure conditions are needed. (LLM, conf=0.84)

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Research works printed but not linked: 5

  1. holzle E, Plewig G, hofmann c, roser-Maass E. Poly- morphous light eruption. Experimental reproduction of skin lesions. J Am Acad Dermatol 1982; 7: 111-125
  2. hawk JLM, Norris PG. Abnormal responses to ultraviolet radiation: idiopathic. In: Freedberg IM, Eisen Az, Katz SI, Wolff K, Goldsmith LA, Austen KF, et al. Fitzpatricks´s dermatology in general medicine, 5th edn. New york: McGraw-hill, 1999: p. 1573-1589.
  3. Tutrone WD, Spann cT, Scheinfeld N, Deleo VA. Poly- morphic light eruption. Dermatol Ther 2003; 16: 28-39.
  4. Berg M, ros AM, Berne B. Utraviolet A phototherapy and trimethylpsoralen UVA photochemotherapy in polymor- phous light eruption -a controlled study. Photodermatol Photoimmunol Photomed 1994; 10: 139-143.
  5. holzle E. PLD -Klinisches Bild und bisheriger Stand des Wissens zur Pathogenese, Prophylaxe und Therapie. Dt Derm 1997; 7: 679-680.

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Authors
Schleye, V., Weber, O., Yazdi, A., Benedix, F., Dietz, K., Röcken, M., & Berneburg, M.
Affiliations
  • University of Tübingen (DE)
  • University of Geneva (CH)
Corresponding author
Berneburg, Mark
Venue
Acta Dermato-Venereologica
Published
2008-09-03
Volume
88
Issue
6
Pages
555-560
ISSN
  • 0001-5555 (ISSN-L)
  • 1651-2057
OpenAlex
W144757342
Cited by
21
References
33
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 2
FWCI
1.79
Type
journal article
Language
en
Open access
Locations
  • Acta Dermato Venereologica (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Dermatology › Skin Protection and Aging
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › melanin and skin pigmentation
  • Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
Keywords
polymorphous light eruption, sunscreen, UVA protection, UVB protection, butyl methoxydibenzoylmethane, photoprotection, minimal erythema dose, prophylaxis
MeSH terms
Alkanes, Female, Humans, Male, Middle Aged, Phenols, Photosensitivity Disorders, Propiophenones, Sunscreening Agents, Triazines, Ultraviolet Rays, Chalcones

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