Lymphocytic infiltration of the skin is a photosensitive variant of lupus erythematosus: evidence by phototesting.
BACKGROUND
Lymphocytic infiltration of the skin (LIS) is a disorder in which photosensitivity has been suspected but never proven.


OBJECTIVE
To carry out a systematic photobiological investigation in patients with LIS and to compare the photobiological features of LIS with those of other photosensitive disorders.


METHODS
We performed provocative phototesting with ultraviolet (UV) A and UVB in 10 patients with active LIS.


RESULTS
In all patients, UVA and/or UVB elicited abnormal papular phototest reactions resembling lesions of LIS both clinically and histologically. Lesions typically developed 3--6 days (mean +/- SD 100.8 +/- 20.9 h) after the first UV exposure.


CONCLUSIONS
This characteristic latency interval together with certain clinical features, i.e. onset in summer, predilection for the face and persistence of the lesions, indicate that LIS is a photosensitive disorder distinct from polymorphic light eruption but indistinct from lupus erythematosus (LE). Both our photobiological findings and the effective treatment with hydroxychloroquine in half of our patients strengthen the proposal that the two entities LIS and LE tumidus are identical. As diagnosis cannot be made by histological, immunofluorescence or laboratory criteria, provocative phototesting may be a diagnostic aid in this disorder.
Department of Dermatology and Venereology, University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. florian.weber@uibk.ac.at
F
F
Weber
M
M
Schmuth
P
P
Fritsch
N
N
Sepp
D000328:Adult; D002465:Cell Movement; D003879:Dermatologic Agents / Q000627:therapeutic use; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008214:Lymphocytes / Q000502:physiology*; D008297:Male; D010787:Photosensitivity Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011446:Prospective Studies; D016896:Treatment Outcome; D014466:Ultraviolet Rays
D003879:Dermatologic Agents; D006886:Hydroxychloroquine