Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China.
Department of Allergy and Immunology, Huashan Hospital Fudan University, Shanghai, China.
Photodermatol Photoimmunol Photomed. 2023 May;39(3):263-268. doi: 10.1111/phpp.12835. Epub 2022 Sep 17.
BACKGROUND/PURPOSE: Chronic actinic dermatitis (CAD) is a spectrum of diseases with chronic photosensitivity occurring mostly among middle-aged and older men. We seek to explore the characteristics and pathogenesis of CAD among the Chinese population.
The medical records of 488 CAD cases diagnosed by phototesting at Huashan Hospital, Fudan University from January 2014 to December 2018 were analyzed retrospectively.
Among the 488 patients, 344 were male and 144 were female. 84.8% of the cases were over 40 years old at the age of onset, while the remaining with an early age of onset had a prevalence of atopic history of 21.6%. Up to 45.0% of the patients reported excessive sun exposure and outdoor activities before the initiation of symptoms. The typical skin lesions were erythema, papules and plaques laid predominantly in sun-exposed areas. 42.8% of the cases showed sensitivity to UVB only, 20.7% were both sensitive to UVA and UVB, and 18.2% had UVA sensitivity only. The most predominant photoallergens were chlorpromazine (80.1%), thimerosal (17.2%), potassium dichromate (12.7%), etc. The most prevalent patch test allergens were potassium dichromate (24.4%), thimerosal (20.5%), formaldehyde (16.8%), etc. CONCLUSIONS: CAD was more commonly seen in males over 40 years old. The action spectrum of Chinese patients is primarily in the UVB range. Exposure to excessive sunlight or contact allergens and photoallergens are important risk factors. Photobiology tests are essential in detecting photosensitivity and recognizing potential photosensitizers. Early avoidance of confirmed photoallergens and sun exposure may prevent photosensitive reactions from progressing into persistent photosensitivity.
背景/目的：慢性光化性皮炎（CAD）是一种以慢性光敏感为特征的疾病谱，主要发生在中老年人，男性居多。我们旨在探讨中国人群 CAD 的特征和发病机制。
回顾性分析 2014 年 1 月至 2018 年 12 月在复旦大学华山医院通过光试验诊断的 488 例 CAD 患者的病历资料。
488 例患者中，男 344 例，女 144 例。发病年龄＞40 岁者占 84.8%，发病年龄较早者特应性病史的患病率为 21.6%。高达 45.0%的患者在症状开始前有过度暴露于阳光和户外活动史。典型皮损为红斑、丘疹和斑块，主要分布于光照暴露部位。42.8%的病例仅对 UVB 敏感，20.7%的病例对 UVA 和 UVB 均敏感，18.2%的病例仅对 UVA 敏感。最常见的光变应原是氯丙嗪（80.1%）、硫柳汞（17.2%）、重铬酸钾（12.7%）等。最常见的斑贴试验变应原是重铬酸钾（24.4%）、硫柳汞（20.5%）、甲醛（16.8%）等。
CAD 多见于 40 岁以上男性，中国患者的作用光谱主要在 UVB 范围内。过度暴露于阳光或接触变应原和光变应原是重要的危险因素。光生物学生物学检测对于检测光敏感性和识别潜在的光致敏原至关重要。早期避免已知的光变应原和阳光照射可能会阻止光敏感反应发展为持续性光敏感。
