中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (12): 1096-1106.doi: 10.35541/cjd.20230433
中国研究型医院学会皮肤科学专业委员会 中国医师协会皮肤科医师分会
收稿日期:
2023-07-28
修回日期:
2023-10-08
发布日期:
2023-12-05
通讯作者:
陈崑;鲁严;顾恒
E-mail:kunchen181@aliyun.com
Dermatology Professional Committee of Chinese Research Hospital Society; China Dermatologist Association
Received:
2023-07-28
Revised:
2023-10-08
Published:
2023-12-05
Contact:
Chen Kun; Lu Yan; Gu Heng
E-mail:kunchen181@aliyun.com
摘要: 【摘要】 慢性光化性皮炎是一种好发于中老年男性的光敏感性皮肤病,临床表现为曝光部位湿疹样改变,诊断主要依靠临床表现和光生物学试验,治疗的关键为避光和去除光敏物,其他治疗包括外用药物、物理治疗及系统药物等。中国研究型医院学会皮肤科学专业委员会、中国医师协会皮肤科医师分会组织光皮肤病学领域专家,依据近年来国内外慢性光化性皮炎的最新研究进展,共同讨论慢性光化性皮炎病因及发病机制、临床表现、诊断、鉴别诊断、治疗和预后等临床实践中重点关注的内容,制订慢性光化性皮炎诊疗专家共识(2023版),以期为临床诊疗提供科学、规范的参考依据。
中国研究型医院学会皮肤科学专业委员会 中国医师协会皮肤科医师分会. [开放获取] 慢性光化性皮炎诊疗专家共识(2023版)[J]. 中华皮肤科杂志, 2023,56(12):1096-1106. doi:10.35541/cjd.20230433
Dermatology Professional Committee of Chinese Research Hospital Society, China Dermatologist Association . Expert consensus on the diagnosis and treatment of chronic actinic dermatitis (2023)[J]. Chinese Journal of Dermatology, 2023, 56(12): 1096-1106.doi:10.35541/cjd.20230433
[1] | Norris PG, Hawk JL. Chronic actinic dermatitis. A unifying concept[J]. Arch Dermatol, 1990,126(3):376⁃378. |
[2] | Lim HW, Buchness MR, Ashinoff R, et al. Chronic actinic dermatitis. Study of the spectrum of chronic photosensitivity in 12 patients[J]. Arch Dermatol, 1990,126(3):317⁃323. doi: 10.1001/archderm.126.3.317. |
[3] | Dawe RS, Ferguson J. Diagnosis and treatment of chronic actinic dermatitis[J]. DermatolTher, 2003,16(1):45⁃51. doi: 10.1046/j.1529⁃8019.2003.01607.x. |
[4] | Yap LM, Foley P, Crouch R, et al. Chronic actinic dermatitis: a retrospective analysis of 44 cases referred to an Australian photobiology clinic[J]. Australas J Dermatol, 2003,44(4):256⁃262. doi: 10.1046/j.1440⁃0960.2003.00004.x. |
[5] | 陈荃, 张美蓉, 梁慕兰, 等. 慢性光化性皮炎95例临床、光试验和光斑贴试验结果分析[J]. 皮肤性病诊疗学杂志, 2017,24(1):27⁃31. doi: 10.3969/j.issn.1674⁃8468.2017.01.007. |
[6] | 李俞晓, 农祥, 何黎, 等. 慢性光化性皮炎及多形性日光疹102例光斑贴试验分析[J]. 临床皮肤科杂志, 2014,43(10):598⁃600. |
[7] | Paek SY, Lim HW. Chronic actinic dermatitis[J]. Dermatol Clin, 2014,32(3):355⁃361. doi: 10.1016/j.det.2014.03.007. |
[8] | Hawk JL. Chronic actinic dermatitis[J]. Photodermatol Photoimmunol Photomed, 2004,20(6):312⁃314. doi: 10.1111/j.1600⁃0781.2004.00129.x. |
[9] | Lee GR. The balance of Th17 versus Treg cells in autoimmunity[J]. Int J Mol Sci, 2018,19(3):730. doi: 10.3390/ijms19030730. |
[10] | Fasching P, Stradner M, Graninger W, et al. Therapeutic potential of targeting the Th17/Treg axis in autoimmune disorders[J]. Molecules, 2017,22(1):134. doi: 10.3390/molecules22010134. |
[11] | Tan KW, Haylett AK, Ling TC, et al. Comparison of demographic and photobiological features of chronic actinic dermatitis in patients with lighter vs darker skin types[J]. JAMA Dermatol, 2017,153(5):427⁃435. doi: 10.1001/jamadermatol.2016.5861. |
[12] | 王丽英, 陈昆, 顾恒, 等. 慢性光线性皮炎紫外线作用光谱的研究[J]. 中华皮肤科杂志, 2005,38(7):410⁃412. |
[13] | 王丽英, 陈昆, 朱登平, 等. 慢性光化性皮炎86例临床分析[J]. 中华皮肤科杂志, 2002,35(6):435⁃438. |
[14] | 陈教全, 梁碧华, 彭丽倩, 等. 330例慢性光化性皮炎患者紫外线最小红斑量测定[J]. 皮肤性病诊疗学杂志, 2021,28(2):105⁃109, 113. doi: 10.3969/j.issn.1674⁃8468.2021.02.005. |
[15] | Gu Q, Zhang Z, Yang J, et al. Chronic actinic dermatitis: a 5⁃year clinical analysis of 488 patients in China[J]. Photodermatol Photoimmunol Photomed, 2023,39(3):263⁃268. doi: 10.1111/phpp.12835. |
[16] | 王广进, 张福仁, 张虹, 等. 慢性光化性皮炎40例临床分析[J]. 中华皮肤科杂志, 2009,42(11):786⁃787. doi: 10.3760/cma.j.issn.0412⁃4030.2009.11.025. |
[17] | Tan AW, Lim KS, Theng C, et al. Chronic actinic dermatitis in Asian skin: a Singaporean experience[J]. Photodermatol Photoimmunol Photomed, 2011,27(4):172⁃175. doi: 10.1111/j.1600⁃0781.2011.00589.x. |
[18] | 李凌佳, 刘彤云, 何黎, 等. 慢性光化性皮炎173例临床与病理分析[J]. 中国皮肤性病学杂志, 2018,32(10):1147⁃1152. doi: 10.13735/j.cjdv.1001⁃7089.201710017. |
[19] | 王丹旭, 闵仲生. 慢性光化性皮炎30例临床分析[J]. 中国麻风皮肤病杂志, 2017,33(12):744⁃745. |
[20] | 赵辨. 中国临床皮肤病学: 上册[M]. 2版. 南京: 江苏凤凰科学技术出版社, 2017:734. |
[21] | Forsyth EL, Millard TP. Diagnosis and pharmacological treatment of chronic actinic dermatitis in the elderly: an update[J]. Drugs Aging, 2010,27(6):451⁃456. doi: 10.2165/11315930⁃000000000⁃00000. |
[22] | Meola T, Sanchez M, Lim HW, et al. Chronic actinic dermatitis associated with human immunodeficiency virus infection[J]. Br J Dermatol, 1997,137(3):431⁃436. |
[23] | Vin⁃Christian K, Epstein JH, Maurer TA, et al. Photosensitivity in HIV⁃infected individuals[J]. J Dermatol, 2000,27(6):361⁃369. doi: 10.1111/j.1346⁃8138.2000.tb02185.x. |
[24] | Wang CX, Belsito DV. Chronic actinic dermatitis revisited[J]. Dermatitis, 2020,31(1):68⁃74. doi: 10.1097/der.000000000000 0531. |
[25] | 中国医师协会皮肤科医师分会过敏与临床免疫亚专业委员, 中华医学会皮肤性病学分会皮肤免疫学组. 光斑贴试验临床应用专家共识[J]. 中华皮肤科杂志, 2015,48(7):447⁃450. doi: 10.3760/cma.j.issn.0412⁃4030.2015.07.001. |
[26] | 中国医师协会皮肤科医师分会皮肤美容事业发展工作委员会. 皮肤防晒专家共识(2017)[J]. 中华皮肤科杂志, 2017,50(5):316⁃320. doi: 10.3760/cma.j.issn.0412⁃4030.2017.05.002. |
[27] | Eadie E, Ferguson J, Moseley H. A preliminary investigation into the effect of exposure of photosensitive individuals to light from compact fluorescent lamps[J]. Br J Dermatol, 2009,160(3):659⁃664. doi: 10.1111/j.1365⁃2133.2008.08998.x. |
[28] | 顾恒, 常宝珠, 陈崑. 光皮肤病学[M]. 北京: 人民军医出版社, 2009:187⁃188. |
[29] | 功效性护肤品在慢性光化性皮炎中的应用指南专家组. 功效性护肤品在慢性光化性皮炎中的应用指南[J]. 中国皮肤性病学杂志, 2020,34(1):1⁃4. doi: 10.13735/j.cjdv.1001⁃7089. 201912048. |
[30] | Moseley H, Cameron H, Macleod T, et al. New sunscreens confer improved protection for photosensitive patients in the blue light region[J]. Br J Dermatol, 2001,145(5):789⁃794. doi: 10.1046/j.1365⁃2133.2001.04429.x. |
[31] | Gröne D, Kunz M, Zimmermann R, et al. Successful treatment of nodular actinic reticuloid with tacrolimus ointment[J]. Dermatology, 2006,212(4):377⁃380. doi: 10.1159/000092291. |
[32] | Uetsu N, Okamoto H, Fujii K, et al. Treatment of chronic actinic dermatitis with tacrolimus ointment[J]. J Am AcadDermatol, 2002,47(6):881⁃884. doi: 10.1067/mjd.2002.124703. |
[33] | Larangeira de Almeida H Jr. Successful treatment of chronic actinic dermatitis with topical pimecrolimus[J]. Int J Dermatol, 2005,44(4):343⁃344. doi: 10.1111/j.1365⁃4632.2005.02352.x. |
[34] | Alquier⁃Bouffard A, Da Costa CM, Roger H, et al. Chronic actinic dermatitis: treatment with topical tacrolimus (two cases)[J]. Ann DermatolVenereol, 2007,134(6⁃7):555⁃558. doi: 10. 1016/s0151⁃9638(07)89268⁃4. |
[35] | 王才惠, 段西凌. 羟氯喹在治疗皮肤病中的应用[J]. 临床皮肤科杂志, 2013,42(4):259⁃261. doi: 10.3969/j.issn.1000⁃4963.2013.04.033. |
[36] | 靳培英. 皮肤病药物治疗学[M]. 2版. 北京: 人民卫生出版社, 2009:132. |
[37] | 阎春林, 廖康煌, 马莉. 羟基氯喹治疗光线性皮肤病的回顾性分析[J]. 临床皮肤科杂志, 2001,30(6):369⁃370. doi: 10.3969/j.issn.1000⁃4963.2001.06.015. |
[38] | Yusuf IH, Latheef F, Ardern⁃Jones M, et al. New recommen⁃dations for retinal monitoring in hydroxychloroquine users: baseline testing is no longer supported[J]. Br J Dermatol, 2021,185(2):435⁃438. doi: 10.1111/bjd.20073. |
[39] | Goldsmith LA, Katz SI, Gilchrest BA, et al. Fitzpatrick′s dermatology in general medicine[M]. 8th edition, New York: McGraw⁃Hill Companies, 2012:1060. |
[40] | Murphy GM, Maurice PD, Norris PG, et al. Azathioprine treatment in chronic actinic dermatitis: a double⁃blind controlled trial with monitoring of exposure to ultraviolet radiation[J]. Br J Dermatol, 1989,121(5):639⁃646. doi: 10.1111/j.1365⁃2133.1989. tb08197.x. |
[41] | Paracha MM, Zahoor H, Khan AQ, et al. Efficacy of methotrexate versus azathioprine in the treatment of chronic actinic dermatitis: a randomized control trial[J]. J Ayub Med Coll Abbottabad, 2022,34(Suppl 1)(3):S644⁃S648. doi: 10.55519/JAMC⁃03⁃S1⁃9643. |
[42] | Chen JC, Lian CH. Chronic actinic dermatitis in an old adult significantly improved by dupilumab[J]. Photodermatol Photoimmunol Photomed, 2022,38(2):176⁃177. doi: 10.1111/phpp.12731. |
[43] | Kaushik A, Narang T, Handa S. Successful use of apremilast as a steroid⁃sparing agent in chronic actinic dermatitis[J]. Dermatol Ther, 2020,33(6):e13809. doi: 10.1111/dth.13809. |
[44] | Patel N, Konda S, Lim HW. Dupilumab for the treatment of chronic actinic dermatitis[J]. Photodermatol Photoimmunol Photomed, 2020,36(5):398⁃400. doi: 10.1111/phpp.12566. |
[45] | Pita da Veiga G, Pérez⁃Feal P, Peña⁃López S, et al. Apremilast⁃induced photosensitivity confirmed by photobiological study[J]. Photodermatol Photoimmunol Photomed, 2021,37(1):68⁃70. doi: 10.1111/phpp.12589. |
[46] | Majid I, Akhtar S. Tofacitinib in resistant chronic actinic dermatitis: a case series[J]. DermatolTher, 2022,35(6):e15467. doi: 10.1111/dth.15467. |
[47] | 中华医学会皮肤性病学分会免疫学组. 特应性皮炎的全程管理共识[J]. 中华皮肤科杂志, 2023,56(1):5⁃15. doi: 10.35541/cjd.20220618. |
[48] | Hindson C, Spiro J, Downey A. PUVA therapy of chronic actinic dermatitis[J]. Br J Dermatol, 1985,113(2):157⁃160. doi: https://doi.org/10.1111/j.1365⁃2133.1985.tb02058.x. |
[49] | Ma L, Zhang Q, Hu Y, et al. Evaluation of narrow band ultraviolet B phototherapy in the treatment of chronic actinic dermatitis in Chinese patients[J]. DermatolTher, 2017,30(6). doi: 10.1111/dth.12528. |
[50] | Wang T, Gong Y, Rong W, et al. Ultraviolet A rush hardening for chronic actinic dermatitis: pilot treatment outcomes[J]. J Dermatol, 2021,48(3):385⁃388. doi: 10.1111/1346⁃8138.15667. |
[51] | 马莉, 胡跃, 徐昱, 等. 窄谱中波紫外线治疗慢性光线性皮炎的方案及影响因素分析[J]. 中华皮肤科杂志, 2017,50(8):571⁃574. doi: 10.3760/cma.j.issn.0412⁃4030.2017.08.006. |
[52] | Chee SN, Novakovic L, Fassihi H, et al. Chronic actinic dermatitis: successful treatment with psoralen⁃ultraviolet A photochemotherapy[J]. Br J Dermatol, 2018,178(3):e189⁃e190. doi: 10.1111/bjd.15969. |
[53] | Lembo S, Raimondo A. Polymorphic light eruption: what′s new in pathogenesis and management[J]. Front Med (Lausanne), 2018,5:252. doi: 10.3389/fmed.2018.00252. |
[54] | Libon F, Nikkels AF. Polymorphous light eruption: phototherapy⁃based desensitization versus intramuscular steroids⁃who is right, who is wrong?[J]. Dermatology, 2018,234(5⁃6):192⁃193. doi: 10.1159/000492749. |
[55] | Dawe RS, Crombie IK, Ferguson J. The natural history of chronic actinic dermatitis[J]. Arch Dermatol, 2000,136(10):1215⁃1220. doi: 10.1001/archderm.136.10.1215. |
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