Polymorphous light eruption (PLE) and a new potent antioxidant and UVA-protective formulation as prophylaxis.
BACKGROUND
Polymorphous light eruption (PLE) is the most common photodermatosis. While its etiology still remains elusive, pathogenesis seems to involve UVA-induced oxidative stress and subsequent deregulation of antioxidative immune responses. Only few and often ineffective prophylactic and therapeutic measures exist to date.


METHODS
In our randomized, double-blind, placebo-controlled clinical study, we compared the efficacy of a new topical formulation, consisting of 0.25%alpha-glucosylrutin (AGR) (a natural, modified flavonoid), 1% tocopheryl acetate (vitamin E) and a broad-spectrum, highly UVA-protective sunscreen (SPF 15) in a hydrodispersion gel vehicle, to a sunscreen-only gel and vehicle. Thirty patients with a history of PLE were pretreated with either the above formulation, a similar preparation (with the same concentration for vitamin E and AGR, but a different UV filter system), placebo or a SPF 15 sunscreen-only gel, 30 min prior to daily photoprovocation with UVA irradiations of 60-100 J/cm(2) to 5 x 5 cm(2) areas on the upper arms.


RESULTS
After 4 days, results revealed a statistically highly significant difference (P<0.001) between the antioxidant containing formulations and placebo, and sunscreen-only formulation, respectively, in experimentally eliciting PLE. While only one patient developed clinical signs of PLE with accompanying itch in the area treated with the new antioxidant UV-protective gel formulation, 62.1% of the placebo-treated areas and 41.3% of the sunscreen-only treated areas showed mild to moderate signs of PLE.


CONCLUSIONS
Combining a potent antioxidant with a broad-spectrum, highly UVA-protective sunscreen is far more effective in preventing PLE than sunscreen alone or placebo and should thus be employed as the prophylaxis of choice for PLE.
Hadshiew
I M
IM
Department of Dermatology and Venerology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. hadshiew@uke.uni-hamburg.de
Treder-Conrad
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C
v Bülow
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R
Klette
E
E
Mann
T
T
Stäb
F
F
Moll
I
I
Rippke
F
F
D000287:Administration, Topical; D000328:Adult; D017454:Dermatitis, Photoallergic / Q000517:prevention & control*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage* / Q000737:chemistry; D005782:Gels; D006801:Humans; D008297:Male; D013473:Sunscreening Agents / Q000008:administration & dosage*; D024505:Tocopherols; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage* / Q000031:analogs & derivatives*
D004338:Drug Combinations; D005419:Flavonoids; D005782:Gels; D013473:Sunscreening Agents; D024502:alpha-Tocopherol; D024505:Tocopherols