Coffin Samuel L, Turrentine Jake E, Cruz Ponciano D
Division of Dermatology, Augusta University, 1004 Chafee Ave, FH-100, Augusta, GA, 30904, USA.
Department of Dermatology, The University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, 75390-9069, USA.
Curr Allergy Asthma Rep. 2017 Jun;17(6):36. doi: 10.1007/s11882-017-0705-2.
The photodermatoses represent a group of disorders of sensitivity to light that continue to pose difficulties in diagnosis and management. Photodermatoses are of interest to allergists because many photosensitive skin disorders have immunologic underpinnings, and patients often present to clinic complaining of "allergy" to the sun. We provide a concise reference for allergists on the clinical recognition and management of photodermatitis.
New developments in the understanding of immunomodulatory effects of light have demonstrated normally immunosuppressive responses in the skin to light exposure, and a blunted immunosuppressive response in the pathogenesis of many photodermatoses. Vitamin D plays an important role in immunomodulation and itself may be affected by photodermatoses due to the impact of photoprotective treatment strategies on circulating vitamin D levels. The elucidation of the immunological basis of many photodermatoses may provide guidance for developing new treatment modalities. Further research is necessary to determine the optimal management of vitamin D metabolism in patients with photodermatoses.
光皮肤病是一组对光敏感的疾病,在诊断和管理方面仍然存在困难。光皮肤病引起过敏症专科医生的关注,因为许多光敏性皮肤病具有免疫学基础,且患者常到诊所抱怨对阳光“过敏”。我们为过敏症专科医生提供一份关于光性皮炎临床识别和管理的简明参考资料。
对光的免疫调节作用的新认识表明,皮肤对光照通常有免疫抑制反应,而在许多光皮肤病的发病机制中免疫抑制反应减弱。维生素D在免疫调节中起重要作用,由于光保护治疗策略对循环维生素D水平的影响,其本身可能受光皮肤病影响。许多光皮肤病免疫基础的阐明可能为开发新的治疗方法提供指导。有必要进一步研究以确定光皮肤病患者维生素D代谢的最佳管理方法。