Acne aestivalis L70.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 28.10.2025

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Synonym(s)

Acne; acne aestivalis; Acne-Prurigo; Mallorca acne; Spring acne; Summer acne

History
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Hjorth, 1972

Definition
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Acne aestivalis, also known colloquially as Mallorca acne, is a genetically predisposed, photoreactive, acneiform (papular) variant of polymorphic light dermatosis. It mainly occurs in people who have spent long periods in the sun on vacation without preparation.

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Manifestation
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Beginning in spring, climax in summer, spontaneous decay in autumn.

Localization
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Sun-exposed areas, especially face, back of upper arm, V-shaped chest and back.

Clinic
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Follicle-bound, acne-like, coarse, small, keratotic papules, sometimes spread over extensive erythema and accompanied by marked itching. The monomorphic disseminated coarse nodules are free of comedones, inflammatory reddening and occasionally abscessing. In contrast to acne vulgaris, comedones and pustules are absent.

Histology
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Follicular ortho- and parakeratotic keratinization with perifollicular inflammatory reaction and partial perforation of the infundibulum epithelium.

General therapy
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Avoid sun exposure or radiation exposure with UVA, no oily sunscreens, rather use gels (see below gels, hydrophilic, gels, hydrophobic), and creams. Restrained therapy, as spontaneous healing without scarring.

External therapy
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Peeling treatments helpful, e.g. aluminium oxide (e.g. Brasivil Peeling fine) or polydimethyl silicone resin (e.g. Jaikin N Paste), tests with vitamin A acid externally as a solution or cream low dosed, e.g. 0.025%-0.05% tretinoin (e.g. Airol solution/cream) or the locally better tolerated Adapalen 0.1% (Differin gel/cream).

Internal therapy
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In case of superinfection systemic antibiotics with minocycline (e.g. Klinomycin) 2 times 50 mg/day p.o. for 3-4 weeks. Photopatch test after completion of the treatment.

Prophylaxis
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Gradually accustom skin to the sun, avoid greasy skin care products, ensure sufficient sun protection (especially textile sun protection).

Note(s)
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Reflected light microscopy: Erythematous round focus with ectatic point and comma vessels, whitish to yellowish-opaque central brightening without comedones (orthohyperkeratosis). Possibly yellowish translucent lacunae (micro-abscedations).

Literature
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Dummer R et al (2003) Clinical and therapeutic aspects of polymorphous light eruption. Dermatology 207: 93-95
Hjorth N, Sjolin KE, Sylvest B et al (1972) Acne aestivalis-Mallorca acne. Acta Derm Venereol (Stockh) 52: 61-63
Plewig G, Jansen T (1998) Acneiform dermatoses. Dermatology. 196: 102-107
Stratigos AJ et al (2003) Spectrum of idiopathic photodermatoses in a Mediterranean country. Int J Dermatol 42: 449-454