慢性光化性皮炎

慢性光化性皮炎是好发于中老年男性的一种光敏性皮肤病，该文叙述了慢性光化性皮炎研究的历史、临床表现、病理和发病机制及临床治疗的进展。     

慢性光化性皮炎18例诊治分析

目的探讨慢性光化性皮炎的临床特点及诊治经验。方法对18例患者的临床资料进行回顾性总结和分析。结果18例患者均为中老年男性,平均年龄63．6岁,平均病程6．3年。皮损均首发于曝光部位,以红斑、丘疹为主要表现,伴瘙痒。组织病理呈慢性皮炎样改变17例,假性淋巴瘤样改变1例。光斑贴试验阳性7例。经严格避光,系统及局部应用糖皮质激素、免疫抑制剂等治疗取得良好疗效。结论本病好发于老年男性,诊断主要依据临床特征、组织病理及光斑贴试验;严格避光及抗炎治疗有效。     

慢性光化性皮炎凋亡蛋白表达的检测

光敏性皮肤病是由日光或其他光线照射后在皮肤上引起多种病变的一组疾病,是皮肤科的多发病,其中慢性光化性皮炎（chronic actinic dermatitis,CAD）好发于中老年男性。本研究观察了几种和细胞凋亡有关的蛋白在患者角质形成细胞中的表达情况,以进一步探讨CAD的发病机制。     

慢性光化性皮炎1例

临床资料患者,男,61岁。主因头面、四肢出现红斑、丘疹伴瘙痒2年加重2个月,于2007年7月来我院就诊。患者2年前额顶部出现数粒黄豆大小散在红色斑疹、丘疹,伴瘙痒,后皮疹渐增多,部分融合成片,波及颈项、躯干及四肢,以曝光部位为主,日晒后加重,冬轻夏重,于外院诊断为"泛发性湿疹",予抗炎抗过敏治     

慢性光化性皮炎2例

慢性光化性皮炎是一组以长期皮肤丘疹、红斑等皮炎样表现的慢性光敏感性皮肤病,临床易误诊。例1男,50岁。面、颈部弥漫性、浸润性红斑1个月,以夏季为重。皮损组织病理示皮炎湿疹样改变,诊断为慢性光化性皮炎,给予羟氯喹口服,外用维生素E霜,目前患者仍在随访中。例2男,55岁。鼻面部弥漫性、浸润性暗红色斑块4～5年,皮损组织病理示淋巴瘤样改变,诊断为慢性光化性皮炎,治疗瞩避光,给予羟氯喹、咪唑斯汀、氯苯那敏口服,外用维生素E霜、丁酸氢化可的松软膏,目前患者仍在随访中。     

97例慢性光化性皮炎患者作用光谱分析

【摘要】 目的 测定慢性光化性皮炎(CAD)的紫外线作用光谱并进一步分析患者病程及日均户外曝光时间对作用光谱最小红斑量(MED)降低的影响。方法 以SUV1000型日光紫外线模拟器为光源,测定108例疑似CAD患者的长波紫外线(UVA)和中波紫外线(UVB)的MED。 结果 108例患者中,97例确诊为CAD。97例患者中,85.57% UVA－MED降低,范围1.02～23.97J/cm2;70.10% UVB－MED降低,范围1.94～19.23mJ/cm2;29.90% 单一UVA－MED下降;14.43% 单一UVB－MED下降。在不同病程组中,>5年组作用光谱的MED显著低于3～5年和<3年组的相应测定值（P<0.01）;3～5年组和<3年组作用光谱的MED之间则无显著性差异（P>0.05）。就日均户外曝光时间而言,>7小时／天组作用光谱的MED显著低于5～7小时／天和<5小时／天组的相应测定值（P<0.01）;而5～7小时／天和<5小时／天组作用光谱的MED之间无显著性差异(P>0.05)。结论 UVA作为CAD的单一作用光谱,不容忽视。且CAD患者病程的发展和户外曝光时间的延长会导致作用光谱MED进一步降低。     

慢性光化性皮炎研究进展

慢性光化性皮炎是一种光敏性皮肤病，好发于中老年白种人男性，发病机制仍未完全清楚，临床表现主要为暴露部位出现慢性苔藓样变，大部分对光敏感，治疗主要是避光、外用糖皮质激素、润滑剂及服用免疫抑制剂。     

330例慢性光化性皮炎患者紫外线最小红斑量测定

目的:分析慢性光化性皮炎(CAD)患者与长波紫外线(UVA)、中波紫外线(UVB)的关系,以及最小红斑量(MED)的影响因素.方法:以SUV1000型日光紫外线模拟器作为照射光源,比较330例CAD患者不同性别、年龄、病程及不同季节受试者UVA-MED值及UVB-MED值.结果:男性患者UVB-MED值明显低于女性ME...     

慢性光化性皮炎发病机制及治疗

慢性光化性皮炎是与日光照射高度相关的慢性光敏性皮肤病,发病机制暂未完全明确,当前普遍认为与紫外线引起的迟发性超敏反应、免疫功能紊乱及炎症反应相关.治疗主要使用预防措施及局部使用糖皮质激素为主,对急性期及重型患者也可使用硫唑嘌呤、环孢素及羟氯喹等进行治疗.可通过手术治疗达到对皮肤外观有严格要求者的期望.     

慢性光化性皮炎1例

1临床资料患者男,63岁,主因面颈部、手背反复红斑、渗出20年加重15d。20年前夏初患者田间劳动后面颈部、手背出现红斑、丘疱疹伴瘙痒,在当地医院按"过敏性皮炎"对症处理后好转,以后每当外出或田间劳动后发作,在家避光后可减轻。20年来皮疹反复发作,以春末至初秋为重,皮损逐渐增厚并形成苔藓性丘疹和斑块,曾多次就诊,并间断外用糖皮     

Evaluation of narrow band ultraviolet B phototherapy in the treatment of chronic actinic dermatitis in Chinese patients

Few studies have been conducted in chronic actinic dermatitis (CAD) treated with narrowband ultraviolet B (NB UVB) phototherapy, especially in Asian patients. We aim to evaluate the efficacy and safety of NB UVB phototherapy in Chinese patients with CAD. 19 CAD patients of Fitzpatrick skin phototype IV received NB UVB phototherapy in spring and treatments were given 3 times weekly with incremental dose and maintenance therapy was given twice weekly for 3–4 weeks. The mean initial, endpoint, and cumulative dose of NB UVB was 0.08, 0.33, and 6.0 J/cm², respectively. Patients totally received 27 times of treatments in average. 87.5% of previously ultraviolet B（UVB） sensitive patients and 75% of previously ultraviolet A（UVA） sensitive patients had normal or improved MED after phototherapy. The percentage of patients returned to normal UVB phototesting was higher than that of patients returned to normal UVA phototesting (68.8% vs. 37.5%). The mean 1‐week DLQI and the need for using immunosuppressive agents and antihistamines were significantly reduced after treatment (p < .01 or p < .05). In conclusion, prophylactic NB UVB phototherapy is effective and safe in treatment of CAD in Chinese patients with Fitzpatrick skin phototype IV.     

慢性光化性皮炎62例临床分析

目的:了解62例慢性光化性皮炎诱发因素、临床和光生物学特征及治疗情况。方法:回顾性分析62例慢性光化性皮炎患者临床资料。结果:62例患者,男女比例为30:1,平均64岁;皮损分布于曝光部位,主要表现为浸润肥厚的红斑、斑块、苔藓样丘疹。病理上早期为光敏性皮炎(PD)象,后期可呈光化性网织细胞增生症(AR)象。光生物学试验测定最小红斑量(MED)中,96.77%患者对UVB敏感,82.26%对UVA敏感;避光和去除光敏物,服用B族维生素和抗组胺药、羟氯喹,局部外用糖皮质激素有较好疗效,严重病例口服小剂量泼尼松和免疫抑制剂可控制病情。结论:慢性光化性皮炎常见于老年男性,临床诊断主要依靠临床表现和光生物学试验、避光和去除光敏物,外用和内服药物是治疗关键。     

Erythrodermic chronic actinic dermatitis responding only to topical tacrolimus

Chronic actinic dermatitis (CAD) is a disorder characterized by an often severe persistent eczematous eruption induced by exposure to ultraviolet radiation. Treatment involves photoprotective measures and topical corticosteroid therapy and in more severe cases, systemic immunosuppression. Occasionally, however, the condition can prove very resistant to all therapy and be severely disabling. We report a patient with CAD who resisted standard topical and systemic treatments, but responded to topical tacrolimus ointment 0.1% (Protopic).     

Tungsten lamp and chronic actinic dermatitis

Chronic actinic dermatitis is often associated with sensitivity to UV light. It is not well recognised that chronic actinic dermatitis may be exacerbated by light in the visible spectrum. We describe an unusual case of chronic actinic dermatitis exacerbated by a tungsten lamp, which emits light in the visible spectrum.     

Diagnosis and treatment of chronic actinic dermatitis

Chronic actinic dermatitis, synonymous with the photosensitivity dermatitis and actinic reticuloid syndrome, presents as a dermatitis and/or a pseudolymphomatous eruption. Abnormal photosensitivity to ultraviolet (UV) and often visible radiation is a feature. Many patients also have multiple contact allergens. Histopathologic features vary, with a spectrum from mild dermatitis to pseudolymphomatous (reticuloid) features. The essential tests to make the diagnosis and to guide advice on avoidance of the responsible wavelengths and any contact allergens are phototesting and patch testing. Chronic actinic dermatitis can be regarded as a disorder of increased susceptibility, for reasons that remain uncertain, to develop delayed-type allergic responses to both endogenous photoallergens and exogenous allergens. Treatment consists of detailed advice on sunlight and allergen avoidance (guided by the results of investigations), topical corticosteroids, and emollients. When these measures are insufficient alone, systemic immunosuppressives may be considered: systemic prednisolone for acute exacerbations or azathioprine if systemic treatment is required for more than a few weeks.     

Musk ambrette and chronic actinic dermatitis

A patient with persistent photosensitivity and positive photopatch tests to musk ambrette and an after-shave lotion is reported. Phototests showed extreme sensitivity to UV radiation, especially UVB. Patch tests with the European Standard Series and some plant allergens were negative. Histology showed a granulomatous reaction with epithelioid and giant cells in the dermis.     

慢性光化性皮炎的组织病理变化

对５１例慢性光化性皮炎（ＣＡＤ）５７个皮肤活检标本的组织病理变化进行了分析，结果表明其组织病理变化呈多形性，为迟缓性变态反应，自早期或活动期的湿疹样皮炎至晚期皮肤Ｔ细胞淋巴瘤样谱系改变。上述不同组织病理变化与同一标本石蜡包埋块中异倍体或二倍体的发现无明显关系，但ＣＡＤ与皮肤恶性淋巴瘤（ＣＭＬ）皮损石蜡包埋块中异倍体的发生率相似，表明ＣＡＤ与ＣＭＬ有某些类同或相关联。     

Cyclosporin A in chronic actinic dermatitis

Two patients with chronic actinic dermatitis received considerable benefit from the administration of cyclosporin A. The drug was initially given at 5 mg/kg/day and then reduced to about 4 mg/kg/day. No side effects have been registered so far. The scanty literature is reviewed. Cyclosporin A may be a useful adjunct to the armamentarium in this difficult-to-manage disorder.     

Chronic actinic dermatitis treated with mycophenolate mofetil

Chronic actinic dermatitis (CAD) is a persistent photodermatosis that usually affects elderly men. We report two male patients, aged 55 years (patient A) and 49 years (patient B), who presented with an eczematous eruption on sun-exposed skin. Phototesting revealed a markedly reduced 24-h minimal erythema dose (MED). Both patients had refractory disease and developed significant side-effects to conventional therapies, including topical steroids, prednisolone, psoralen with ultraviolet A, azathioprine and ciclosporin. They had each received at least 6 years of treatment prior to commencing mycophenolate mofetil (MMF). Each noted a significant improvement in symptoms within 6 weeks and subsequent clearing of the eczematous lesions. Patient A still requires continuous treatment with MMF 500 mg twice daily to prevent relapses. Patient B maintains remission by using MMF 1 g twice daily only during the spring and summer months. Both patients have tolerated the treatment well with no abnormalities in blood cell counts or liver biochemistry. Since commencing MMF, their quality of life has significantly improved. These observations suggests that MMF should be considered as an alternative treatment to conventional therapies for refractory CAD.