Juvenile spring eruption
Juvenille spring eruption |
Clinical features
- Localised polymorphic light eruption.
- Usually presents in early spring.
- More common in boys and young men with short hair, as their ears are exposed.
- Presents within 24 hours of sun exposure.
- Itchy papulo-vesicular rash on the auricle. May form blisters.
- Enlarged cervical lymph glands.
- Healing occurs spontaneously within two weeks.
- Tends to remit in summer but may recur each year.
Management
- Treatment speeds healing.
- Emollients.
- Topical potent steroid.
- Antihistamines for itching.
- Recurrences reduced by growing hair, wearing hats and using sunscreens.
Perniosis of the ear
Perniosis may ulcerate |
Clinical features
- Most common in women and sometimes familial.
- Induced by cold, damp situations.
- Perniosis (chilblains) may also affect extremities, ie feet and hands, fingers, toes and nose.
- May also occur in association with lupus erythematosus (LE), viral hepatitis, HIV, rheumatoid arthritis and chronic myelomonocytic leukaemia.
- Recurrent, painful, tender erythematous/violaceous plaques on the auricle.
- May complain of itchy and burning sensation.
- May blister and ulcerate.
- Usually occur during the winter months.
- Perniosis is usually a clinical diagnosis but investigate if in doubt.
- Skin biopsy.
- Positive antinuclear antibodies would suggest LE.
Management
- Avoid exposure to cold.
- Nifedipine 10mg three times daily or 20mg twice daily.
- Nicotinamide 500mg three times daily.
- Topical hexyl nicotinate.
- Amlopidine 2.5-5mg daily.
- UV light to affected areas at the start of the cold season.
- Sympathectomy in severe cases.
Contributed by Dr Jean Watkins, a sessional GP in Hampshire.
