Acne aestivalis
Medical condition
From Wikipedia, the free encyclopedia
Acne aestivalis (also known as Mallorca acne) is a seasonal skin condition and a type of polymorphous light eruption caused by ultraviolet A (UVA) radiation. It is characterised by uniform red papules that typically appear between 24 and 72 hours after sun exposure, most commonly on the shoulders, upper arms, chest, and back.[1][2][3] This condition was first seen in both men and women aged 20-40 years in Mallorca following sun exposure after the winter season.[1]
| Acne aestivalis | |
|---|---|
| Other names | Mallorca acne |
| Specialty | Dermatology |
Signs and symptoms
Patients present with numerous small papules that are dull red, dome shaped, hard, and usually 2–4 mm in diameter. These lesions typically affect the lateral upper arms, shoulder girdle, back, and chest. The face is typically not affected.[1] The papules appear 24-72 hours after sun exposure and may last for several weeks. Comedones are not present in this type of skin reaction.[1]
Cause and pathophysiology
The condition is triggered by exposure to UVA. The exact pathophysiology of acne aestivalis is not well understood.[1]
It is suggested that a genetic predisposition may be a contributory factor due to a lower expression of apoptosis-inducing genes, leading to inflammation triggered by circulating ultraviolet-damaged cells that fail to undergo apoptosis and the cell fragments they release.[4]
It is also speculated that cosmetics and sunscreen containing hydroxyl peroxides may contribute to this condition through phototoxic reactions caused by free radical release during ultraviolet-induced oxidation.[5][2][1]
Diagnosis, treatment, and prognosis
Diagnosis is based on clinical examination of skin lesions and a history of recent sun exposure. A diagnosis is made when the patient reports the onset of papules occurring 24-72 hours after sun exposure.[1]
Treatment for this condition typically involves topical tretinoin or benzoyl peroxide. The use of topical steroids should be avoided. There is currently no systemic treatment for acne aestivalis.[1] The papules do not typically result in scarring.[1]
Epidemiology
There is limited information on the epidemiology of this condition. It affects men and women equally between the ages of 20 and 40 with no prior history of acne vulgaris. It is a seasonal skin condition, most common in spring and summer when there is greater sun exposure compared to autumn and winter.[1]
Research
In 2001, a study was conducted to test a prophylaxis regimen containing alpha-glucosylrutin, a strong plant-derived antioxidant. The focus of the experiment was to evaluate the effects of alpha-glucosylrutin on polymorphous light eruption and acne aestivalis development. The study demonstrated that applying alpha-glucosylrutin along with SPF 15 sunscreen decreases severe polymorphous light eruption cases from 96.2% to 7.4%. The study included 20 people with polymorphous light eruption and three people with acne aestivalis. In this study, two out of the three people with acne aestivalis did not have an episode of lesions after being prophylactically treated with alpha-glucosylrutin and SPF 15.[6]