Stinco Giuseppe, Codutti Rolando, Frattasio Alfonsina, De Francesco Vincenzo, Patrone Pasquale
Institute of Dermatology, University of Udine, Via Battifero 1, 33013 Germona del Friuli (UD), Italy.
Eur J Dermatol. 2002 Sep-Oct;12(5):455-7.
Chronic actinic dermatitis (CAD) groups together all chronic photodermatosis with light photosensitivity. We report the case of a 69-year-old man who, for over one year, had presented a reddish-brown erythema and shedding, with thickened and hypo-elastic skin on the face, scalp, neck and on the back of the hands and forearms. Patch tests were positive to isoeugenolo 1% and photo-patch tests showed a positivity to phenotiazine 2%. After a short and ineffective treatment with beta-carotene and photo-protectors, the clinical picture was resolved with the administration of oral steroids but with a relapse of the dermatitis once the dosage was lowered. We therefore started treatment with cyclosporine-A (4.5 mg/kg/die), which resulted in a rapid improvement of the clinical picture, but with a reappearance of the manifestations when the dosage was lowered. The treatment was resumed and we observed that the dose of 1.5/mg/kg/die resulted morbus-static. The patient is still being treated with this drug at this dosage. The result is that the disease is under control and no side effects are present. As we consider CAD an invalidating disease it seems to us that Cy-A could be taken into consideration as an alternative to traditional treatments.
慢性光化性皮炎（CAD）是所有伴有光过敏的慢性光皮肤病的统称。我们报告一例69岁男性患者，一年多来，其面部、头皮、颈部以及手背和前臂出现红棕色红斑及脱屑，皮肤增厚且弹性减退。斑贴试验对1%异丁香酚呈阳性，光斑贴试验对2%吩噻嗪呈阳性。在使用β-胡萝卜素和光保护剂进行了短期且无效的治疗后，给予口服类固醇使临床症状得到缓解，但剂量降低后皮炎复发。因此我们开始使用环孢素A（4.5毫克/千克/日）进行治疗，临床症状迅速改善，但剂量降低时症状又再次出现。恢复治疗后，我们观察到1.5毫克/千克/日的剂量使病情静止。该患者目前仍以这个剂量接受此药治疗。结果是疾病得到控制且无副作用出现。由于我们认为CAD是一种使人衰弱的疾病，在我们看来，环孢素A可以被视为传统治疗方法的替代选择。
