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Polymorphic light eruption — SCE Dermatology MCQ

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HardPhotodermatologyPolymorphic light eruptionSCE Dermatology

A woman has severe polymorphic light eruption each spring despite broad-spectrum sunscreen, protective clothing and behavioural photoprotection. She wants prophylaxis before an outdoor expedition in May. Which specialist intervention is most suitable?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: EA supervised pre-season course of narrowband UVB phototherapy to induce hardening

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · A = shown as D · C = shown as E

C is correct. In severe recurrent polymorphic light eruption, a supervised course of phototherapy before the sunny season can induce skin hardening and reduce subsequent reactions. Narrowband UVB is commonly used, with dose escalation controlled to minimise provocation and burns. One intense exposure is unsafe and does not reproduce a graded desensitisation course. Doxycycline itself can cause photosensitivity and does not prevent PLE. Photopatch testing diagnoses photoallergic contact dermatitis rather than treating PLE. Photoprotection remains necessary because hardening is not complete or permanent, and systemic immunosuppression is reserved for exceptional refractory disease.

Reference: BAD polymorphic light eruption information: https://www.bad.org.uk/pils/polymorphic-light-eruption