中华皮肤科杂志 ›› 2002, Vol. 35 ›› Issue (6): 435-438.

• 论著 • 上一篇    下一篇

慢性光化性皮炎86例临床分析

王丽英, 陈昆, 朱登平, 常宝珠, 张小华, 陈琴芳, 郑治菊, 杨夕芳, 郑家润, 李光中   

  1. 中国医学科学院、中国协和医科大学皮肤病研究所 南京 210042
  • 收稿日期:2002-01-29 出版日期:2002-12-15 发布日期:2002-12-15
  • 通讯作者: 常宝珠,Email:Changbaozhu21805@sina.com E-mail:Changbaozhu21805@sina.com

Clinical Analysis of 86 Cases with Chronic Actinic Dermatitis

WANG Liying, CHEN Kun, ZHU Dengping, CHANG Baozhu, ZHANG Xiaohua, CHEN Qinfang, ZHENG Zhiju, YANG Xifang, ZHENG Jiarun, LI Guangzhong   

  1. Insititute of Dermatology, Chinese Academy of Medical Sciences &Peking Union Medical College, Nanjing 210042, China
  • Received:2002-01-29 Online:2002-12-15 Published:2002-12-15

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摘要： 目的 探讨慢性光化性皮炎诱发因素、临床和光生物学特征以及治疗情况.方法 回顾性分析86例慢性光化性皮炎患者临床资料.结果 86例患者,男女比率11.29:1,平均发病年龄57.1岁.20.9%有明确诱发因素,78.9%日晒可诱发或加重皮损.初次发病多在春季,随病程延长,季节性逐渐消失.皮损分布于光暴露部位,急性发作表现为红斑、丘疹、渗出、结痂,病情迁延后出现浸润肥厚的苔藓样丘疹(45.5%)、斑块(37.3%).光生物学试验中77.9%患者中波紫外线最小红斑量(UVB-MED)降低,范围4～20mJ/cm2.95.3%患者长波紫外线MED(UVA-MED)降低,范围0.2～15J/cm2.光斑贴试验证实了14例患者的光敏物.避光和去除光敏物,急性发作期外用或口服小剂量皮质类固醇可控制病情.反复发作后部分患者自然缓解.结论 光生物学试验是诊断慢性光化性皮炎的主要依据,避光和去除光敏物是治疗关键.

关键词: 皮炎, 光变应性

Abstract: Objective To study the precipitating factors, clinical features, photobiological test features and therapy in patients with chronic actinic dermatitis. Methods Clinical data of 86 cases with chronic actinic dermatitis were analyzed retrospectively. Results The male:female ratio was 11.29:1. The average age of onset was 57.1 years. Of the 86 patients, 20.9% were found to have definite precipitating factors and 78.9% with a light exacerbating history. The first on set often took place in spring. The seasonal predominance gradually disappeared along with prolongation of clinical course of the disease. Lesions were distributed primarily or most severely on the exposed skin and consisted of erythema, papules, exudation, crusting, sometimes thickened papules(45.5%)and plaques(37.3%). A lowered ultraviolet-B minimal erythema dose (MED) was found in 77.9%of patients, ranging from 4 mJ/cm2 to 20 mJ/cm2. A lowered ultraviolet-A MED was found in 95.3% of patients, ranging from 0.2 J/cm2 to 15 J/cm2. Photoallergens were confirmed in 14 patients by photopatch test. Therapy with ultraviolet light and photoallergens avoidance, broadspectrum sunscreens, topical or systemic cort icosteroids was effective in most cases. Spontaneous remission was found in some patients after repeated relapses. Conclusions Diagnosis of chronic actinic derm atitis depends mainly on the clinical features and results of photobiological tests. Appropriate ultraviolet light and photoallergen avoidance are important in the therapy.

Key words: Dermatitis, photoallergic