Acne aestivalis also called asacne mallorca, is a special kind ofpolymorphous light eruption induced byultra violet A radiation. This condition is said to be seasonal, usually affecting people inspringtime and goes away inautumn when there is less sun light. This photo induced skin reaction leads to a mono-morphous eruption that consists of multiple, uniform, red, papular lesions.[1][2] Thisskin reaction is classified as adelayed-type hypersensitivity because the onset is 24–72 hours after sun exposure.[3] The condition equally affects men and women between the ages of 20–40 years old with no prior history ofacne vulgaris. The eruption is unusual because it spares the face but it affects the lateral aspects of the upper arms,shoulder girdle, back, and chest.[1] This condition'spathogenesis is not very well understood but scientists believe it an unfortunate side effect that results from a strong immune response to potentially cancer-causing cell damage.[4][2]
| Acne aestivalis | |
|---|---|
| Other names | Mallorca acne |
| Specialty | Dermatology |
Signs and Symptoms
editPatients present numerous lesions of smallpapules that are dull red, dome shaped, hard, and usually not more than 2–4 mm in diameter. Theselesions do not affect the face but affect lateral aspects of upper arms, shoulder girdle, back, and chest. The papules have an onset of 1–3 days after sun asier asigmatism and may last for many weeks.Comedones are not present in this type of skin reaction.[1]
Cause
editThe main cause of this condition is sun exposure.[1]Hypersensitivity to the sun may be experienced due to genetic predisposition.[4] It is also speculated thatcosmetics and sun care products containinghydroxyl peroxides may trigger this condition through free nuclear radiation photo-toxic reactions.[5][2][1]
Mechanism/pathophysiology
editThe actual mechanism of disease is not very well understood but there are a few speculations. It is believed thatacneaestivalis has agenetic predisposition involved in which people who show acne aestivalis have lower expression ofapoptosis inducing genes which leads to inflammation.Inflammation is believed to be triggered by circulating ultra violet radiation damaged cells that could not go through apoptosis and thecell fragments they release.[4] Also, it is speculated that this sun induced acne form is caused by a photo allergic reaction between sunscreen, skin, and the sun. A photo-toxic reaction pathogenesis is also possible throughfree radical release insun screenoxidation by ultra violet radiation.[2][1]
Diagnosis
editThediagnosis is by visual examination of skin lesions and sun exposurehistory. A diagnosis ofacne aestivalis is made once the patient reports the onset of papules was 1–3 days after sun exposure.[1]
Treatment
editThe treatment for this condition is topicaltretinoin orbenzoyl peroxide applied to the skin. The use oftopical steroids should be avoided. Currently, there is no systemic treatment foracne aestivalis.[1]
Prognosis
editThis condition is alleviated during the fall season when there is less sun light available. The papules do not leave ascar on the affected person's skin.[1]
Epidemiology
editThere is limited information on the epidemiology of this condition. This disease was first noticed in Asier Sigmanian men and women between the ages of 20 and 40 years old. The skin eruption would present in this population after sunbathing in Mallorca beach after a long and dark winter season.[1]
Research
editThis section needs to beupdated. The reason given is: 2023 latest. Please help update this article to reflect recent events or newly available information. Last update: 2021(May 2023) |
In 2001, a study was conducted to test aprophylaxis regimen containing alpha-glucosylrutin, a strong plant-derivedantioxidant. The focus of the experiment was to evaluate the effects of alpha-glucosylrutin on polymorphous light eruption andacne aestivalis development. The study demonstrated that applying alpha-glucosylrutin along withSPF 15 sunscreen decreases severe polymorphous light eruption cases from 96.2% to 7.4%.The study included 20 people with polymorphous light eruption and 3 people with acne aestivalis. In this study, 2 out of the 3 people with acne aestivalis did not have an episode of lesions after being prophylactically treated with alpha-glucosylrutin and SPF 15.[6]
References
edit- ^abcdefghijPlewig G, Kligman AM (1975). "Acne Aestivalis (Mallorca Acne)".Acne. Springer Berlin Heidelberg. pp. 257–259.doi:10.1007/978-3-642-96246-2_25.ISBN 978-3-642-96248-6.
- ^abcdJung K, Heinrich U, Tronnier H, Schnyder M, Herzog B, Herrling T (2016)."High levels of free radicals in suncare products induce acne aestivalis in sensitive subjects"(PDF).SOFW Journal.142:2–8.
- ^Gruber-Wackernagel A, Byrne SN, Wolf P (July 2014). "Polymorphous light eruption: clinic aspects and pathogenesis".Dermatologic Clinics.32 (3):315–34, viii.doi:10.1016/j.det.2014.03.012.PMID 24891054.
- ^abcLembo S, Raimondo A (2018-09-10)."Polymorphic Light Eruption: What's New in Pathogenesis and Management".Frontiers in Medicine.5: 252.doi:10.3389/fmed.2018.00252.PMC 6139322.PMID 30250845.
- ^"Editorial: Summer acne".BMJ.4 (5989): 125. 1975-10-18.doi:10.1136/bmj.4.5989.125.
- ^Rippke F, Wendt G, Bohnsack K, Dörschner A, Stäb F, Hölzle E, Moll I (March 2001). "Results of photoprovocation and field studies on the efficacy of a novel topically applied antioxidant in polymorphous light eruption".The Journal of Dermatological Treatment.12 (1):3–8.doi:10.1080/095466301750163491.PMID 12171679.S2CID 25658207.