HYDROA VACCINIFORME

By Gary M. White, MD


Hydroa vacciniforme (HV) is a rare photosensitivity disorder of childhood associated with Epstein-Barr virus (EBV). Recurrent erythema and vesicles after sun exposure with onset in childhood is characteristic. The disease is not inherited, but siblings have been affected.

Differential Diagnosis

Hydroa vacciniforme-like lymphoma (HVLL) should be considered in the differential diagnosis. Indeed, various patients with atypical HV have gone on to develop neoplasms (e.g., subcutaneous T-cell lymphoma, CD8+ cutaneous lymphoma). Some of these patients have had infiltrated T-cells shown to contain latent Epstein-Barr virus infection [JAAD 2015;72;21]. HVLL, in addition to the classic features of HV, also includes marked facial edema, large ulcerative cutaneous lesions, hemorrhagic bulla, atrophic scars, and severe disfigurement in both sun-exposed and photo-protected sites.

See also hypersensitivity to mosquito bites.

Treatment

Sun avoidance, protective clothing, and sunscreens should be used. Special plastic film may be applied to the windows of the home and the car to minimize UV exposure. The disease usually remits during adolescence.

References

Ann Dermatol. 2010 Aug; 22(3): 312–315.

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