Photosensitivity is commonly detected in patients with SLE. The frequency of photosensitivity varies with the geographical region and the specific lupus cohort studied. For example, our group reported a 45% frequency of photosensitivity in 150 patients with SLE evaluated in the Mid-Atlantic states in the United States (Hochberg et al. 1985). The late James Gilliam living in Dallas, Texas, believed that almost all of his patients with SLE were photosensitive (personal communication). Other studies have indicated that patients with subacute cutaneous LE (SCLE) possessing anti-Ro/SSA antibodies have an 80%-90% frequency of photosensitivity (Mond et al. 1989, Simmons-O'Brien et al. 1995). Indeed, many of these patients burn through window glass, indicating that low-energy long-wave ultraviolet (UV) light is capable of activating their disease.

Provocative phototesting has indicated that various subsets of lupus erythematosus (LE) have different frequencies of photosensitivity (Kuhn et al. 2001, Table 7.3); however, photosensitivity also occurs in patients with dermatomyositis (DM). Indeed, in recent years ours as well as other groups of investigators have become aware of a group of patients with DM without clinical evidence of muscle disease (amyo-pathic DM; DM sine myositis) who are frequently referred to a dermatologist because of the presence of a photosensitive erythematous dermatosis thought to be LE (Euwer and Sontheimer 1991, Stonecipher et al. 1993). We have evaluated 33 of these patients over the past 15 years. At least 75% of these patients have noted that their dermatitis is exacerbated by ultraviolet light exposure. At the present time, this author is unaware of any studies investigating the roles of UVA, UVB, or both wavelengths and provocative phototesting in these DM patients.

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