Juvenile spring eruption of the ears

Juvenile spring eruption: an outbreak report and systematic review of the literature

BACKGROUND

Juvenile spring eruption of the helices of the ears is a distinctive sun-induced condition appearing on the light-exposed skin of the ears, typically in boys and young men in early spring.

OBJECTIVES

To determine clinical features and outcome of juvenile spring eruption of the ears.

METHODS

We report a new outbreak in 14 Swiss-Italian children. A systematic search of the literature was also performed.

RESULTS

Five outbreaks in children involved a total of 203 cases (boys, 72%), and three outbreaks in young adults involved 223 male subjects. A further 54 sporadic cases were found: 41 among children (boys, 97%) and 13 among young adult males. The typical presentation included itching and diffuse erythema of both ears starting in the evening after exposure to bright sunlight during cold weather, followed within 24-48 h by papules or blisters. No other organ system was involved. The subjects recovered spontaneously without sequelae within 1-2 weeks. In New Zealand, among 162 school-aged boys, 20 developed the condition.

CONCLUSIONS

A limitation is that the analysis was based upon the scanty available literature. Juvenile spring eruption is a self-limiting and generally easy recognizable variant of polymorphic light eruption. Outbreaks tend to appear on sunny and cold spring days. Paediatricians and general practitioners might rapidly develop the skills necessary to clinically appreciate this condition.

Juvenile Spring Eruption: A Report of Two Cases

Juvenile spring eruption is a photodermatosis characterized by the development of papules and vesicles on the light-exposed helix of the ears after sun exposure, usually in the springtime. It mainly affects boys and young male adults, and has a tendency to occur in the form of small epidemics. We report an outbreak in a group of soldiers who were performing military exercises during cold and sunny weather during a midwinter season. The clinicopathologic features and laboratory test results are described in two of these cases.

Juvenile spring eruption: clinicopathologic features and phototesting results in 4 cases

Juvenile spring eruption is a distinct photodermatosis characterized by the development of papules and vesicles on light-exposed areas of the ears usually in the early springtime. It primarily affects boys and young men, and has a tendency to occur in the form of small epidemics. We report a similar outbreak in separate groups of soldiers who were performing military exercises during cold and sunny weather of a midwinter season. The clinicopathologic features and phototesting results are described in 4 of these cases. All patients showed normal erythemal responses to monochromator phototesting with UV and visible wave bands. Photoprovative testing with repeated daily exposures of the ears to a broadband UVA source provoked diffuse erythema and itching in 1 case, whereas similar photoprovocation of a nonaffected area, ie, the flexor surface of the forearm, in 2 patients did not yield a skin reaction. Although the cause of juvenile spring eruption is not known, our observations further strengthen the hypothesis that the disorder is a localized variant of polymorphous light eruption.

Diseases associated with photosensitivity

Photosensitive disorders may be classified as those entirely caused by solar exposure and the photoaggravated disorders. Those in the former category include polymorphic light eruption, juvenile spring eruption, actinic prurigo, hydroa vacciniforme, solar urticaria, also chronic actinic dermatitis. Genodermatoses whose expression mainly depends on UV or light exposure include the DNA repair deficient disorders, some disorders of cornification, the Smith-Lemli-Opitz syndrome and porphyria. Examples of photoaggravated diseases include lupus erythematosus, erythema multiforme, atopic eczema, psoriasis, viral exanthemata, pemphigus, dermatitis herpetiformis and rosacea. Drugs and chemicals may interact with UV to induce photosensitivity. In many of these diseases the action spectrum is known or may be determined by phototesting. Recognition of the reaction patterns associated with the photodermatoses greatly assists clinical classification of the photodermatoses.

Juvenile spring eruption of the ears: a probable variant of polymorphic light eruption

We report 18 cases in which a pruritic, erythematous, papular and vesicular eruption developed on the ears following sun exposure. Four of these patients had, on other occasions, suffered from typical polymorphic light eruption. The clinical features, histological changes, and results of phototesting suggest that juvenile spring eruption of the ears is a localized form of polymorphic light eruption.