| • | probably an “excoriated” variant of PMLE |
| • | most commonly seen in of Central and North America |
| • | begins in childhood (75% have positive family history) |
| • | intensely pruritic and eczematous; becomes impetiginized |
| • | photo-distributed; most commonly girls |
| • | does not harden, often resolves within 5 years |
| • | treatment = low dose thalidomide (drug of choice) |
ddx summary:
| • | actinic prurigo (eczematous) (girls); probably an “excoriated” variant of PMLE |
| • | hydroa vacciniforme (papulovesicular) (boys); might represent a “scarring” variant of PMLE |
histology:
| • | similar to PMLE: mild acanthosis, exocytosis and spongiosis with moderate lymphohistiocytic infiltrate (biopsy rarely aids diagnosis) |
hereditary pmle
| • | native Americans; autosomal dominant |
| • | indistinguishable clinically from AP except that it persists much more frequently into adulthood |
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