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For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
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What is the diagnosis?
Polymorphous light eruption (PMLE).
What causes it?
Unaccustomed exposure to the sun; both long wave ultraviolet radiation (UVA) and short wave ultraviolet radiation (UVB) may be responsible. PMLE usually occurs after several days of sun exposure, and may occur even in those using sunscreens. It generally settles after several days, providing the skin is protected from further sun exposure. In a few, the rash may develop a rash after relatively short periods outdoors during the spring and summer.
How can she prevent it?
Sun protective measures are usually adequate, i.e. avoiding prolonged periods outdoors, wearing covering clothing, and applying broad-spectrum sunscreens to exposed skin frequently. Severely affected individuals should be referred to a dermatologist. The following prophylactic treatments may help: systemic steroids, hydroxychloroquine, UVB and photochemotherapy (PUVA).
How should she be treated?
Moderately potent topical steroids applied twice daily reduce the severity of the reaction. Cooling emollients provide symptomatic benefit. The affected areas should be protected from further sun exposure for several days.