Allergic to the sun (Polymorphic light eruption) – you may need UVB or vitamin D

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Photosensitivity (sun allergy) and vitamin D in VitaminDWiki

Photosensitivity (sun allergy) and vitamin D

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Patients with polymorphic light eruption have decreased serum levels of 25-hydroxyvitamin-D3 that increase upon 311 nm UVB photohardening.

Photochem Photobiol Sci. 2012 Dec;11(12):1831-6. doi: 10.1039/c2pp25188d.
Gruber-Wackernagel A, Obermayer-Pietsch B, Byrne SN, Wolf P.
Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria.

BACKGROUND: Polymorphic light eruption (PLE) is a very common condition whose pathogenesis may involve immunological abnormalities.
Vitamin D sufficiency is thought to be important for normal immune function.

OBJECTIVE: To determine whether PLE patients are vitamin D deficient and to study how photohardening with 311 nm UVB affects the vitamin D status of PLE patients.

METHODS: The vitamin D status of 23 PLE patients (21 females and 2 males; age range, 18-55 years) was analysed at four different time points (early spring, late spring, summer, and winter) by measuring 25-hydroxyvitamin-D(3) (25(OH)D) serum levels through a standardised immunoassay.
Fifteen of those patients received 311 nm UVB in early spring for prevention of PLE symptoms.
25(OH)D levels of the PLE patients were compared to that of 23 sex-, age-, and body-mass-index post hoc-matched control subjects.

RESULTS: PLE patients had low levels of 25(OH)D throughout the year compared to that of the control subjects. At baseline in early spring, the mean ± SD 25(OH)D level was 14.9 ± 3.0 ng ml(-1) in the PLE patients that would later receive 311 nm UVB and 14.4 ± 2.4 ng ml(-1) in the patients not receiving 311 nm UVB. Successful prophylactic treatment with 311 nm UVB significantly increased 25(OH)D levels to a mean of 21.0 ± 3.4 ng ml(-1) (p < 0.001; ANOVA, Tukey's test). Heading into summer, the 25(OH)D levels in treated patients decreased again, reaching their lowest levels in winter. In contrast, the 25(OH)D levels of untreated PLE patients stayed in the low range in early and late spring but increased by trend towards summer, reaching similar levels to that of the PLE patients who had received 311 nm UVB (17.1 ± 2.3 vs. 17.3 ± 6.0 ng ml(-1)). Like the treated PLE patients, 25(OH)D levels of untreated patients significantly decreased in winter to comparable levels (12.2 ± 1.9 vs. 13.8 ± 1.8 ng ml(-1)). Taken together, the 25(OH)D levels of PLE patients were significantly lower at all time points than that observed in the matched control population (34.4 ± 12.5 ng ml(-1)) (p < 0.000003).

CONCLUSIONS: PLE patients have low 25(OH)D serum levels. 311 nm UVB phototherapy that prevented PLE symptoms increased those levels.
Thus, we speculate that boosting levels of vitamin D may be important in ameliorating PLE.

PMID: 22952008

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Wikipedia PLE highlights

• Polymorphous light eruption (PLE), or polymorphic light eruption (PMLE), is a skin condition caused by sunlight.
• Symptoms include skin irritations, which may be itchy or painful, and are sometimes confused with hives.
    These irritations appear upon exposure to sunlight—sometimes only hours after exposure —and may last from 1 to 7 days.
• The cases of this condition are most common between the spring and autumn months in the northern hemisphere.
• Typically, 5-20% of fair skinned populations are affected, but it can occur in any skin type
• The cause of PLE is not yet understood. It is thought to be due to a type IV delayed-type hypersensitivity to an allergen produced in the body following sunlight exposure
• Some progression to autoimmune disease has been observed.

Clinical trial of Vitamin D to treat PLE – ending Dec 2014

• Vitamin D intervention: total dose of 80,000 IU vitamin D3 per 70 kg body weight (not much)

Dermatological Phototherapy and Photodiagnostic Methods book

• narrowband UVB is considered the treatment of first choice for PLE

Prevention of Polymorphous Light Eruption and Solar Urticaria PLE sunscreens need to block UVA

• Sunscreens which blocked UVA were the best at preventing PLE
• Did not seem to matter if UVB was blocked or not {quick read}
• In a recent series of 110 patients, PLE could be photoinduced with visible light
  23 patients were also sensitive to UVB and UVA {Wonder if that was a sensitivity to (UVA AND UVB), or (UVA OR UVB) separately}

Results of RCT of vitamin D-like compound July 2011

• Cream contained calcipotriol, a vitamin D analog

Skin hardening effect in patients with PLE: UV hardening in home Jan 2013, < 6 minutes a day.

UV lamp had higher ratio of UVB/UVA than most tanning beds
Vertical axis = Impact of PLE on quality of life: Quality of Life improved by 10X. PLE Impact dropping from 15.5 down to 1.5
Horizontal Axis = before treatment, immediately after UV treatment, 2 months later (people could continue with the UV treatments)

{VitaminDWiki suspects that there would have been even better results using bulbs which had NO UVA}
PDF is attached at the bottom of this page

Polymorphic Light Eruption (PLE)

• excellent medical description of PLE, apparently before 2010
• 5% in Australia,
• 10% in the United States,
• 15% in the United Kingdom and approximately
• 15% - 20% in the most northerly latitudes of Europe

http://mysunallergy.com/ compares many ways that a person used to reduce PLE

 

Comments by VitaminDWiki

• Appears that allergy to sun is an allergy to UVA when a person has low levels of vitamin D.
• Can increase the vitamin D levels through

1. Vitamin D3 supplementation: capsules, spray, liquid, etc.
2. Creams made with vitamin D analogs (and apparently Vitamin D3 as well)
3. UVB – as short as 6 minutes per day (not a tanning bed – which also has UVA)
   Vitamin D from low-cost UVB lamps
4. Special Plexiglass-silver panel should block all UVA from the sun
   Business opportunity: you can now make stuff which only passes vitamin D wavelength