Photoaggravated pompholyx

Abstract

To the Editor, Pompholyx is a type of eczema characterized by a pruritic vesicular eruption occurring on the lateral fingers, hands and feet (1, 2). Many aetiological factors such as atopy, contact allergy, adverse drug reactions, dermatophyte and HIV infection are reportedly associated, and stress, smoking, irritants and prolonged use of protective gloves are said to be aggravating factors (2). One of the important cutaneous adverse effects of intravenous immunoglobulin (IVIG) was pompholyx, which developed in 62.5% of the 64 patients who had eczematous reactions to IVIG (3). Hyperhidrosis may be an aggravating factor in up to 40% patients, and improvement has been observed after botulinum toxin A injections (4, 5). Pompholyx can be affected by seasonal changes, hot and cold temperatures, and is worse in summer as reported by a study in 6300 children aged 0-16 years in Turkey (1, 6). Interestingly, sunlight was reported to successfully treat pompholyx after failing ultraviolet A (UVA) therapy (7); however, the role of sunlight as an aetiological factor is rarely reported. We present 3 patients with the infrequently reported condition of photoaggravated pompholyx, with 2 of these showing positive provocation on phototesting.