title: Polymorphous light eruption (PLE) and a new potent antioxidant and UVA-protective formulation as prophylaxis.
abstract: 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.
authors.affiliation: Department of Dermatology and Venerology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. hadshiew@uke.uni-hamburg.de
authors.forename: I M
authors.initials: IM
authors.lastname: Hadshiew
authors.forename: C
authors.initials: C
authors.lastname: Treder-Conrad
authors.forename: R
authors.initials: R
authors.lastname: v Bülow
authors.forename: E
authors.initials: E
authors.lastname: Klette
authors.forename: T
authors.initials: T
authors.lastname: Mann
authors.forename: F
authors.initials: F
authors.lastname: Stäb
authors.forename: I
authors.initials: I
authors.lastname: Moll
authors.forename: F
authors.initials: F
authors.lastname: Rippke
mesh_terms: 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*
chemical_list: D004338:Drug Combinations; D005419:Flavonoids; D005782:Gels; D013473:Sunscreening Agents; D024502:alpha-Tocopherol; D024505:Tocopherols