Skin nontumor

Dermal perivascular and vasculopathic reaction patterns

Polymorphous light eruption

Last author update: 1 August 2011
Last staff update: 18 January 2021

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PubMed Search: Polymorphous light eruption

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Polymorphous light eruption. website. Accessed February 23rd, 2024.
Definition / general
  • The most common photodermatosis
  • Presents in young adults as recurrent erythematosus papules, vesicles or plaques on face, chest, upper back and extremities
  • Onset of lesions 18 - 24 hours after light exposure, usually in spring / summer
  • Associated with thyroid disease or lupus in some patients
  • Juvenile spring eruption appears to be either a form of polymorphous light eruption or a closely related disorder
  • Use photo testing to establish diagnosis
Clinical images

Images hosted on other servers:

Polymorphic light eruption on arm

Microscopic (histologic) description
  • Perivascular lymphohistiocytic infiltrate in superficial and sometimes deep dermis
  • Papillary dermal edema; epidermal acanthosis, spongiosis, occasional dyskeratotic cells and lymphocytic exocytosis
  • Basal cell vacuolation is mild
  • Periadnexal involvement may be seen; variable increase in eosinophils and neutrophils
Positive stains
  • Direct immunofluorescence shows C3, IgM and IgG at basal layer of dermoepidermal junction
Differential diagnosis
  • Actinic reticuloid: dense cellular and interstitial infiltrate of papillary and reticular dermis that may extend to subcutaneous fat; composed of variable lymphocytes, histiocytes, eosinophils and plasma cells; multinucleated giant cells are conspicuous; also large atypical hyperchromatic cerebriform lymphoid cells and blast forms
  • Gyrate erythema such as lymphocytic infiltration of Jessner
  • Reticulae erythematous mucinosis: has dermal mucin, not present in polymorphic light eruption
  • SLE
Additional references
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