Blisters (on ears)

• aetiology is unknown
  • although the exact pathogenesis of the disease is not known, juvenile spring eruption (JSE) is considered to be a localized variant of polymorphous light eruption (PLE)
    • mainly on the basis of its distinct epidemiologic and clinical features such as the occurrence in spring and summer, the delayed appearance of lesions several hours after exposure to sunlight, and the transient and often recurrent course of the eruption
    • histology and immunohistology of JSE lesions are also compatible with PLE
      
      
• primarily affects boys and young men, and has a tendency to occur in the form of small epidemics
  
  
• particularly affects boys in the early spring months following exposure to sunlight
  
  
• dull-red oedematous papules, many of which become vesiculous, appear most commonly on the light-exposed helices of the ears. The lesions heal without scarring unless secondary infection occur
  
  
• attacks tend to occur with decreasing frequency and generally resolve by the time the child is three years of age
  
  

Click here for an example image of this condition

Management (2)

• UV exposure
  • careful and graduated light exposure in Spring may help patients become tolerant before they go on holiday
• holidays
  • for moderate cases consider prednisolone EC tablets, 25 mg OD for five days starting the day before their holiday (if away for two weeks give an extra five days' supply to use if needed)
• referral
  • for more severe cases refer for consideration of phototesting and further management, eg phototherapy in Springtime to promote tolerance (12-16 exposures gives four months of protection), IM depot steroids and in severe cases immunosuppressive drugs such as azathioprine

Reference:

• Stratigos AJJ et al. Juvenile spring eruption: clinicopathologic features and phototesting results in 4 cases. Am Acad Dermatol. 2004 Feb;50(2 Suppl):S57-60
• Primary Care Dermatological Society.Juvenile spring eruption and polymorphic skin eruption (Accessed 29/7/14)