Acne Estivalis

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The lesions seen here developed shortly after a 54-year-old woman started psoralen plus UVA (PUVA) therapy for psoriasis. This is acne estivalis, an uncommon actinic, acneiform eruption. The firm, red, monomorphic papules are most commonly found on the shoulders, arms, neck, and chest. Histologically, they resemble steroid acne. Lesions develop in the spring, peak in the summer, and resolve in the fall without scarring.

The lesions seen here developed shortly after a 54-year-old woman started psoralen plus UVA (PUVA) therapy for psoriasis. This is acne estivalis, an uncommon actinic, acneiform eruption. The firm, red, monomorphic papules are most commonly found on the shoulders, arms, neck, and chest. Histologically, they resemble steroid acne. Lesions develop in the spring, peak in the summer, and resolve in the fall without scarring.

Another name for the condition is Mallorca acne, because it affected many Scandinavians who visited this southern European island. As in this case, acne estivalis occurs also in patients receiving UVA treatment, with or without psoralen. This woman's lesions cleared after cessation of PUVA therapy. This photo was sent by Drs Charles E. Crutchfield III and Eric J. Lewis of Minneapolis.