Juvenile spring eruption
The most common time for presentation of JSE is in the early spring when the weather is still cold. It is thought that sunlight exposure and cold weather both have a role in the induction of JSE. There is a tendency for JSE to occur in small epidemics, for example, at boys' schools or among a group of soldiers.
JSE is characterized by grouped small papules, papulovesicles, or true vesicles on the helices of the ears. Lesions typically develop within 24-48 hours after exposure to sunlight and cold conditions and are typically pruritic. Vesicles may rupture and crust. Lesions resolve spontaneously, usually within 2 weeks, with minimal to no scarring. There are no systemic symptoms or organ involvement. Recurrence during the following spring has been reported. The condition tends to improve with age and resolve in young or middle adulthood.
Pathogenesis is thought to be a delayed-type hypersensitivity to an endogenous photoinduced allergen and/or lack of ultraviolet radiation (UVR)-induced immunosuppression. The spectrum of UV light that induces the condition is UVA in most cases; rarely, UVB or visible light may incite JSE.
L56.4 – Polymorphous light eruption
238526000 – Juvenile spring eruption
Differential Diagnosis & Pitfalls
- Actinic prurigo (another variant of PLE)
- Hydroa vacciniforme
- Solar urticaria
- Lupus erythematosus
- Photosensitive drug eruption
- Photoallergic contact dermatitis (see PLE)
- Congenital disorders of metabolism with photosensitivity when presenting in young children (eg, porphyria, Hartnup disease)