慢性光化性皮炎95例临床、光试验和光斑贴试验结果分析  

Clinical features and photobiological evaluation in 95 cases of chronic actinic dermatitis

作　　者：陈荃[1] 张美蓉[1] 梁慕兰[1] 王立新[1] 黄茂芳[1] 李振洁[1] 龚业青[1] 朱慧兰[1] 

机构地区：[1]广州市皮肤病防治所,广东广州510095

出　　处：《皮肤性病诊疗学杂志》2017年第1期27-31,共5页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：广州市医药卫生科技项目(编号:20141A011072);广东省医学科学技术研究基金项目(编号:A2015331)

摘　　要：目的:了解慢性光化性皮炎的临床特点,检测慢性光化性皮炎的致病光谱和光接触性变应原。方法:收集我所近七年诊断为"慢性光化性皮炎"并完成光生物学试验的患者,共95例。进行长波紫外线(UVA)、中波紫外线(UVB)的最小红斑量(MED)测定以及光斑贴试验。结果:患者中男60例,女35例;平均年龄53.04岁;全部为Ⅳ型皮肤。皮损主要分布于光暴露部位。光试验结果:UVA-MED 87例(91.58%)低于正常值,UVB-MED 53例(55.79%)低于正常值,两者均异常为51例(53.68%)。光斑贴试验中阳性反应59例(62.11%)。主要的光变应原为盐酸氯丙嗪(41.05%)、盐酸异丙嗪(21.05%)、硫双对氯酚(18.95%)、香料混合物(9.47%)和秘鲁香脂(9.47%)。结论:临床表现和光生物学试验是诊断慢性光化性皮炎的重要依据。Objective：To investigate the clinical manifestation of chronic actinic dermatitis （CAD） and to reveal the action light spectra and photoallergens of CAD. Methods：A total of 95 patients who met the diagnostic criteria of CAD and completed the photobiological test were enrolled from January 2009 to December 2015 in our outpatient department. The minimal erythema dose （MED） of ultraviolet A （UVA） and ultraviolet B （UVB） radiation was carried out. Meanwhile, the photopatch test was performed. Results：There were 60 males and 35 females. The average age was 53.04 years. All 95 patients were Fitzpatrick skin type IV. Lesions were mainly distributed at the photo-exposed area. Among 95 CAD patients, 87 （91.58%） patients had lower UVA-MED than the normal range, and 53 （55.79%） cases were sensitive to UVB. Both UVA- MED and UVB-MED were abnormal in 51 （53.68%） patients. Photopatch tests were positive in 59 （62. 11% ） patients. The most common photoallergens were chlorpromazine hydrochloride （41.05%）, promethazine hydrochloride （ 21.05% ）, fenticlor （ 18.95% ）, perfume mixture （9.47%） and Peru balsam （9.47%）. Conclusion： Clinical manifestation and photobiological test are necessary for the diagnosis of CAD.

关 键 词：慢性光化性皮炎 光试验 光斑贴试验 最小红斑量 光变应原 

分 类 号：R758.14[医药卫生—皮肤病学与性病学]