Hereditary polymorphic light eruption is a form of photosensitivity found in the American Indians of the central plains of Canada and the United States and in the Indians of Central and South America. The disorder has also been ... Hereditary polymorphic light eruption is a form of photosensitivity found in the American Indians of the central plains of Canada and the United States and in the Indians of Central and South America. The disorder has also been called familial actinic prurigo, solar dermatitis, and hydroa aestivale. In northern latitudes, skin lesions appear on exposed areas early in spring, become severe during the summer, and abate in the fall. Usually the disorder appears in childhood with eczematous crusted eruptions on the face and arms. Fissured, crusted exudative cheilitis develops on the lips, especially the lower lip. The dorsum of the hands, the laterodorsal aspects of the forearms, and the lower half of the arms often show excoriated papular and nodular lesions. Children frequently have complicating pyoderma. Adults usually exhibit an erythematous plaquelike eruption on the face and other exposed areas. The disease is more severe in children than in adults. Glomerulonephritis can follow streptococcal pyoderma (summary by Fusaro and Johnson, 1980).
Some hours after sun exposure, actinic prurigo patients experience an intense pruritus and develop a dermatosis on the face and exposed areas. Skin signs include erythematous weeping areas, vesicles, papules, nodules, and plaques. Excoriations are common. The lips ... Some hours after sun exposure, actinic prurigo patients experience an intense pruritus and develop a dermatosis on the face and exposed areas. Skin signs include erythematous weeping areas, vesicles, papules, nodules, and plaques. Excoriations are common. The lips and conjunctivae are often affected. The skin lesions may extend onto covered areas. In most persons clearing occurs in the winter, but for some the dermatosis persists throughout the year. An exacerbation is experienced by all patients in the summer. Of 128 AP patients reported from Manitoba, 70% had onset before the age of 10 years (Birt and Davis, 1975). In a Saskatchewan series of 93 AP patients, Lane et al. (1992) found that 45% had an age of onset younger than 9 years and 72% had onset before the age of 20 years. Females were twice as likely to be affected as males in the Birt and Davis (1975) study and 3 times as likely to be affected in the study of Lane et al. (1992). Berth-Jones et al. (1991) reported 18 cases of juvenile spring eruption of the ears: a pruritic, erythematous, papular and vesicular eruption developing on the helix of the ear following sun exposure, especially in boys aged 5 to 12 years (Anderson et al., 1954). They concluded that juvenile spring eruption is a localized form of polymorphic light eruption. They reported a family in which the condition had occurred in a father and 4 sons and pointed to the reports of familial nature of polymorphous light eruption by Jansen (1978) and Ros and Wennersten (1986).