慢性光化性皮炎86例临床分析  

Clinical Analysis of 86 Cases with Chronic Actinic Dermatitis

作　　者：王丽英[1] 陈昆[1] 朱登平[1] 常宝珠[1] 张小华[1] 陈琴芳[1] 郑治菊[1] 杨夕芳[1] 郑家润[1] 李光中[1] 

机构地区：[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

出　　处：《中华皮肤科杂志》2002年第6期435-438,共4页Chinese Journal of Dermatology

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。Objective To study the precipitating factors, clinical features, p hotobiological test features and therapy in patients with chronic actinic dermat itis. Methods Clinical data of 86 cases with chronic actinic dermatitis were ana lyzed retrospectively. Results The male:female ratio was 11.29:1. The average ag e 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 distribu ted primarily or most severely on the exposed skin and consisted of erythema, pa pules, 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 w ere 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 te sts. Appropriate ultraviolet light and photoallergen avoidance are important in the therapy.

关 键 词：慢性光化性皮炎 临床分析 CAD 病因 诊断 治疗 

分 类 号：R758.1[医药卫生—皮肤病学与性病学]