Mps Sawhney1, S Arora2, A Khetrapal3. 1. Senior Advisor (Dermatology & STD), Base Hospital, Delhi Cantt. 2. Classified Specialist (Dermatology & STD), 5 Air Force Hospital, C/o 99 APO. 3. Commanding Officer and Senior Advisor (Pathology), Armed Forces Transfusion Centre, Delhi Cantt.
Abstract
BACKGROUND: Photosensitivity to Chlamydia trachomatis has been described in almost 50% of chronic cases of lymphogranuloma venereum (LGV) caused by L1, L2 or L3 serovars. Photosensitivity in non LGV strains of C trachomatis has not been studied. We studied the association of various photosensitive dermatoses with C trachomatis infection in non LGV cases. METHODS: Sera of all the cases of photosensitivity, melasma, chronic actinic dermatitis (CAD), polymorphic light eruption (PLE), actinic prurigo (AP) and rosacea were tested for the presence of IgM, IgG and IgA antibodies to C trachomatis by ELISA method. The results were compared with 30 healthy controls. RESULT: Seventeen (25.53%) of 57 cases of photosensitivity as against two (6.67%) controls were seropositive for IgM/IgG/IgA antibodies, a statistically significant difference (χ(2) 6.18, p 0.013). Similarly, significantly higher seropositivity was observed in 12 (25.53%) of 47 cases of melasma (χ(2) 4.38, p 0.0363) and six (46.15%) of 13 cases with CAD (χ(2) 6.91, p 0.0086). Although higher proportion of patients of rosacea [five (31.25%) of 16 cases] and PLE [four (25.0%) of 16 cases] were seropositive, the difference was not statistically significant (χ(2) 3.23, p >0.05, OR 6.36, CI 95% 0 to 48 and χ(2) 3.09, p 0.078, OR 4.67, CI 95% 5 to 41 respectively). There was no association of AP. CONCLUSION: The observations suggest that C trachomatis infection in non LGV cases is an important cause of PS, melasma and CAD. It appears to be an important cause of rosacea and PLE. We recommend that all cases of photosensitivity, melasma, CAD, PMLE and rosacea and their spouses/sexual contacts be investigated for C trachomatis infection.
BACKGROUND: Photosensitivity to Chlamydia trachomatis has been described in almost 50% of chronic cases of lymphogranuloma venereum (LGV) caused by L1, L2 or L3 serovars. Photosensitivity in non LGV strains of C trachomatis has not been studied. We studied the association of various photosensitive dermatoses with C trachomatis infection in non LGV cases. METHODS: Sera of all the cases of photosensitivity, melasma, chronic actinic dermatitis (CAD), polymorphic light eruption (PLE), actinic prurigo (AP) and rosacea were tested for the presence of IgM, IgG and IgA antibodies to C trachomatis by ELISA method. The results were compared with 30 healthy controls. RESULT: Seventeen (25.53%) of 57 cases of photosensitivity as against two (6.67%) controls were seropositive for IgM/IgG/IgA antibodies, a statistically significant difference (χ(2) 6.18, p 0.013). Similarly, significantly higher seropositivity was observed in 12 (25.53%) of 47 cases of melasma (χ(2) 4.38, p 0.0363) and six (46.15%) of 13 cases with CAD (χ(2) 6.91, p 0.0086). Although higher proportion of patients of rosacea [five (31.25%) of 16 cases] and PLE [four (25.0%) of 16 cases] were seropositive, the difference was not statistically significant (χ(2) 3.23, p >0.05, OR 6.36, CI 95% 0 to 48 and χ(2) 3.09, p 0.078, OR 4.67, CI 95% 5 to 41 respectively). There was no association of AP. CONCLUSION: The observations suggest that C trachomatis infection in non LGV cases is an important cause of PS, melasma and CAD. It appears to be an important cause of rosacea and PLE. We recommend that all cases of photosensitivity, melasma, CAD, PMLE and rosacea and their spouses/sexual contacts be investigated for C trachomatis infection.