[开放获取]   慢性光化性皮炎诊疗专家共识（2023版）

doi:10.35541/cjd.20230433

Abstract

Abstract: 【Abstract】 Chronic actinic dermatitis is a photosensitive dermatosis commonly occurring in middle-aged and elderly males, clinically characterized by eczematous lesions on the sun-exposed skin. The diagnosis mainly relies on clinical manifestations and photobiological tests. The key to treatment is avoidance of sunlight exposure and removal of photosensitizers, and other treatments include topical drugs, physical therapy, systemic drugs, etc. Based on recent research advances in chronic actinic dermatitis in China and other countries, the Dermatology Professional Committee of Chinese Research Hospital Society and the China Dermatologist Association organized experts in the field of photodermatology to discuss the causes, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment and prognosis of chronic actinic dermatitis in clinical practice, and to develop an expert consensus on the diagnosis and treatment of chronic actinic dermatitis （2023）, which provided a scientific and authoritative reference for the diagnosis and management of chronic actinic dermatitis.

Key words: Dermatitis, photoallergic, Chronic actinic dermatitis, Diagnosis, Therapy, Expert consensus

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

References ［55］

［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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Expert consensus on the diagnosis and treatment of chronic actinic dermatitis （2023）

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