Kingston T P, Lowe N J, Sofen H L, Weingarten D P
J Am Acad Dermatol. 1987 May;16(5 Pt 2):1079-83. doi: 10.1016/s0190-9622(87)70138-8.
A 61-year-old black man suffering from actinic reticuloid with contact allergy to four substances, extreme sensitivity to both ultraviolet A and ultraviolet B, normal visible light sensitivity, and negative results on photopatch tests was placed on a regimen of azathioprine, 50 mg twice a day. At 3 months, clinical appearance was unchanged, as was his strong contact allergy; however, tolerance to natural sunlight was markedly improved. At 6 months the clinical appearance and ultraviolet responses were normal; however, strong contact allergy persisted. To our knowledge, this is the first report of actinic reticuloid in a black person. Azathioprine, after giving an excellent clinical response without leukopenia, was discontinued. A further 9-month follow-up showed continued remission. The persistence of contact allergy, despite profound improvement in photosensitivity and the skin's appearance, suggests that the role of contact allergy in the cause of actinic reticuloid is unclear, and the existence and identity of the hypothesized photosensitizer(s) in actinic reticuloid remain unproved.
一名61岁的黑人男性患有光化性类网状细胞增生症，对四种物质有接触性过敏，对紫外线A和紫外线B极度敏感，对正常可见光敏感，光斑试验结果为阴性，接受了硫唑嘌呤治疗方案，每日两次，每次50毫克。3个月时，临床症状未变，强烈的接触性过敏也未改变；然而，对自然阳光的耐受性明显改善。6个月时，临床症状和紫外线反应正常；然而，强烈的接触性过敏仍然存在。据我们所知，这是黑人中光化性类网状细胞增生症的首例报告。硫唑嘌呤在未引起白细胞减少的情况下产生了良好的临床反应，随后停药。进一步的9个月随访显示病情持续缓解。尽管光敏性和皮肤外观有显著改善，但接触性过敏仍然存在，这表明接触性过敏在光化性类网状细胞增生症病因中的作用尚不清楚，光化性类网状细胞增生症中假设的光敏剂的存在和特性仍未得到证实。
