CORRELATION BETWEEN CLINICAL AND HISTOPATHOLOGICAL PATTERNS IN PATIENTS WITH PHOTO DERMATOSES
Main Article Content
Keywords
Photodermatoses, Papular Lesions, Histopathological Findings.
Abstract
Background: Photodermatoses are a category of conditions arising from atypical skin responses to sun radiation. These include idiopathic photodermatoses , drug induced photodermatoses, DNA repair-defect photodermatoses, and photo-aggravated dermatoses. Their differential diagnosis is challenging; therefore, it is essential to correlate the clinical and histological results
Methods
An observational study was done among patients diagnosed clinically to have photodermatoses, who presented to Department of Dermatology, Trichy SRM Medical College Hospital and Research Centre to correlate clinical and histopathological findings. A total of 150 patients with clinically diagnosed photodermatoses were enrolled for the study. A semi-structured questionnaire was used to gather information. Detailed information about demographic details with the data regarding occupation, outdoor activity, dressing habits, symptoms, aggravating factors and associated medical conditions was observed and collected; the patient underwent a physical and cutaneous examination by a single dermatology resident to avoid inter-observer variation. The lesion was examined for the distribution, morphology, primary and secondary lesions. Skin biopsy was taken for the purpose of histopathological examination and a clinical photograph was also documented for all cases. Data were entered and analysed using SPSS statistical package IBM version 2.1.
Results
Participants were mostly between the ages of 18 and 30 (46%), with those between the ages of 31 and 40 (28%), coming in second. Of the sample, 54.66% (82 participants) were female, and 45.33% (68 participants) were male. 103 participants, or 68.66% of the total, reported engaging in outdoor activities frequently. Plaques were the most prevalent lesion shape among the patients with photodermatoses, occurring in 61.33% of cases, followed by papules (52%) and macules (24%). Among 150 cases of photodermatoses, polymorphous light eruption (PMLE) was the most prevalent clinical diagnosis, occurring in 87 (58%) of cases. Out of 87 cases of PMLE, 23 cases (26.43%), 43 (49.42%) and 21 cases (24.13%) were reported as acanthosis, spongiosis and exocytosis as a histopathology findings. In PPD diagnosed 26 cases, orthokeratotic hyperkeratosis, hyergraulosis, acanthosis were observed among 10 (38.46%), 11 (42.3%) and 5 (19.23%) cases respectively. All the cases (15 cases) of DLE were showed orthokeratic hyperkeratosis.
Conclusion
This observational study compares various photodermatoses with corresponding histological findings. Women in their second to fourth decade of life are more commonly affected by photodermatoses. Micro-papular and papular lesions are the predominant clinical presentation. The diagnosis of photodermatoses is primarily clinical; however, histopathological examination is necessary in ambiguous cases to exclude other differential diagnoses.
References
[2] Fourtanier A, Moyal D, Seite S. UVA filters in sun-protection products: regulatory and biological aspects. Photochem Photobiol Sci 2012;11(1):81-9.
[3] Walker SL, Hawk JLM. Acute and chronic effects of ultraviolet radiation on the skin. In: Freedberg IM, Eisen AZ, eds. Fitzpatrick’s dermatology in general medicine. 6th edn. New York: McGraw Hill 2003:1275-82
[4] Lehmann P, Schwarz T. Photodermatoses: diagnosis and treatment. Dtsch Arztebl Int 2011;108(9):135-41.
[5] Krupashankar DS. Photodermatology and photodermatoses. In: Sacchidanand S, Oberai C, Inamdar AC, eds. IADVL Textbook of Dermatology. 4th edn. Mumbai: Bhalani 2015: p. 901.
[6] Yashar SS, Lim HW. Classification and evaluation of photodermatoses. Dermatol Ther 2003;16(1):1-7.
[7] Verma K, Rokde R, Singh U. A clinicoepidemiological and histo-Pathological study of polymorphic light eruptions in Malwa region. IP Indian J Clin Exp Dermatol 2019;5(1):24-9.
[8] Jansen CT, Darvonen J. Polymorphous light eruption. A seven year follow up evaluation of 114 patients. Arch Dermato. 1984;120:862.
[9] Khaitan B, Ramam M, Sharma V, et al. Photosensitive spongiotic/ lichenoid eruption of micropapules and plaques: a morphologically distinct entity. Indian J Dermatology Venereol Leprol 2013;79(4):497.
[10] Lehmann P, Schwarz T. Photodermatoses: diagnosis and treatment. Dtsch Ärztebl Int 2011;108(9):135-41.
[11] Krupashankar DS SK. Photodermatology and photodermatoses. In: Sacchidanand S, Oberai C, Inamdar AC, eds. IADVL Textbook of Dermatology. 4th edn. Mumbai: Bhalani 2015; p. 901.
[12] Prabhu SS. Investigations and treatment of photodermatoses. Indian J Skin Allergy 2024;3:45-53.
[13] Saraswat A, Godghate D, Thakre MS, et al. A clinico-histopathological correlation of various photodermatoses. IJTPR 2023;13(7):181-6.
[14] Oakley AM, Ramsey ML. Polymorphic Light Eruption. In: Treasure Island (FL): StatPearls Publishing 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430886
[15] Chopra D, Ravinder S, RK Bahl, et al. Various clinical and histopathological patterns of idiopathic photodermatosis: an observational study. Journal of Clinical and Diagnostic Research 2018;12(11):WC01-4.
[16] Merin KA, Shaji M, Kameswaran R. A review on sun exposure and skin diseases. Indian J Dermatol 2022;67(5):625.
[17] Prasad P, Kaviarasan PK, Udhay S. A Clinicopathological Study of PMLE. Journal of Cosmetics, Dermatological Sciences and Applications 2012;2:219-23.
[18] Bedi TR. Summertime actinic lichenoid eruption. Dermatologica 1978;157(2):115-25
[19] Wadhwani AR, Sharma VK, Ramam M, et al. A clinical study of the spectrum of photodermatoses in dark-skinned populations. Clin Exp Dermatol 2013;38(8):823-9.
[20] Pullabatla P, Kaliyaperumal KP, Sidhu U. A clinico-pathological study of PMLE in Chidambaram. J Cosmet Dermatol Sci Appl 2012;2(3):219-23.
[21] Sharma L, Basnet A. A clinic epidemiological study of PMLE. Indian J Dermatol Venerol Leprol 2008;74:15-7.
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Dr. J. Ann Jenita
Postgraduate, Department of Dermatology, Venereology and Leprosy, Trichy SRM Medical College Hospital and Research Centre Irungalur, Trichy, Tamil Nadu, India.
Dr. R. Gnanasekaran
Professor and HOD, Department of Dermatology, Venereology and Leprosy, Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy, Tamil Nadu, India.
Dr. T. Rajalakshmi
3Postgraduate, Department of Dermatology, Venereology and Leprosy,Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy, Tamil Nadu, India.