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。

Analysis of 62 cases with chronic actinic dermatitis

Objective:To investigate the causative factors,clinical and photobiogical characteristics,and the effect of treatment in 62 patients with chronic actinic dermatitis(CAD).Methods:Clinical data from 62 cases with CAD were analyzed retrospectively.Results:The male:female ratio was 30:1.The average age was 64 years.Skin lesions were primarily distributed over the exposed areas,manifesting as infiltrated fleshy erythema,speckle and lichenification papules.The pathology of the disease was PD phase in early stage of the disease and AR phase in late stage of the disease.99.7% and 82.5% of the patients were sensitive to UVB and UVA tested by photo-test(minimal erythema dose).Avoiding sun exposure,removing photosensitive materials and treatment with vitamin B,antihistamines,Hydroxychloroquine and topical corticosteroids were effective.Treatment in combination of small dose prednisone and immuno-depressive drugs resulted in satisfactory effect in some advanced cases.Conclusion:CAD often occurs in elderly man.The diagnosis of CAD mainly depends on clinic manifestations and the photobiological test.Protection from sunlight exposure,avoidance of photosensitive materials and treatment are the most important measures in the management of CAD.