Impact assessment of energy-efficient lighting in patients with lupus erythematosus: A pilot study

Background: Patients with lupus erythematosus (LE) are often abnormally photosensitive. Ultraviolet (UV) exposure can not only induce cutaneous lesions but may also contribute to systemic flares and disease progression. Various forms of energy-efficient lighting have been shown to emit UV radiation. 

Objectives: To determine the effects of these emissions on individuals with LE. 

Methods: This assessment investigated cutaneous responses to repeated exposures from three types of lighting: compact fluorescent lamp (CFL), light-emitting diode (LED) and energy-efficient halogen (EEH). The subjects were 15 patients with LE and a control group of five healthy volunteers. 

Results: No cutaneous LE lesions were induced by any of the light sources. Delayed skin erythema was induced at the site of CFL irradiation in six of the 15 patients with LE and two of the five healthy subjects. Erythema was increased in severity and more persistent in patients with LE. One patient with LE produced a positive delayed erythema to the EEH. A single patient with LE produced immediate abnormal erythemal responses to the CFL, LED and EEH. Further investigation revealed that this patient also had solar urticaria. All other subjects had negative responses to LED exposure. 

Conclusions: Compact fluorescent lamps emit UV that can induce skin erythema in both individuals with LE and healthy individuals when situated in close proximity. However, this occurs to a greater extent and is more persistent in patients with LE. EEHs emit UVA that can induce erythema in patients with LE. LEDs provide a safer alternative light source without risk of UV exposure. What's already known about this topic? Patients with lupus erythematosus (LE) can have abnormal cutaneous response to ultraviolet (UV) radiation. Compact fluorescent lamps (CFLs) emit UV that can exacerbate certain photodermatoses. UV-induced cutaneous response may lead to general disease progression including systemic activity. What does this study add? Skin erythema is induced by repeated CFL exposure in healthy individuals and those with LE. CFL-induced erythema is more persistent in individuals with LE. Light-emitting diodes offer a safe alternative light source for individuals with LE, without the risk of UV.