No mortality is associated with typical hydroa vacciniforme. Females have a higher incidence of HV than males and report earlier onset. Affected males have a longer course of disease. Cases of HV in infants and the elderly also have been described. Imaging studies are not routinely ordered as part of the work-up of hydroa vacciniforme.
Early lesions reveal an epidermal, multilocular vesicle with reticular degeneration.
A dense, perivascular, lymphohistiocytic infiltrate with vessel hemorrhage and thrombosis may occur in the dermis. Late lesions show epidermal and dermal necrosis with a surrounding, chronic, inflammatory infiltrate. The most common severe sequela is the varioliform scarring. Consult ophthalmology for evaluation and management of associated eye findings. Other therapies that have been used with varying success include thalidomide, azathioprine, cyclosporine, and fish oil supplementation.