Ortel B, Tanew A, Wolff K, Hönigsmann H
J Am Acad Dermatol. 1986 May;14(5 Pt 1):748-53. doi: 10.1016/s0190-9622(86)70088-1.
Polymorphous light eruption is a common seasonal photodermatosis with a typical history and clinical picture. In the interval, when no lesions are present, the diagnosis relies on artificial reproduction of polymorphous light eruption by phototesting. Photochemotherapy (psoralens with ultraviolet A [PUVA]) is currently an effective preventive treatment. One hundred sixty-seven patients with either a history of polymorphous light eruption or manifest disease entered our study. Of 142 patients tested, 49% developed typical lesions of polymorphous light eruption at the test sites. In 56% the action spectrum was found to be in the ultraviolet A range, in 17% in the ultraviolet B range, and in 26% in both ranges. A total of 122 patients received preventive treatment with PUVA. Of these, fifty-one returned for follow-up. Of the patients who were followed up, 64% reported total protection during outdoor activities in the summer, 26% reported partial protection, and 10% were not protected. Failure to improve was unrelated to the action spectrum. The action spectrum and the incidence of positive results on phototests in our patient population differed from those reported by others. It is possible that differences in the test protocols and in the light sources used may account for this discrepancy. There is clearly a need for a standardized test procedure. However, the majority of patients benefit from PUVA pretreatment regardless of their action spectrum.
多形性日光疹是一种常见的季节性光皮肤病，具有典型的病史和临床表现。在无皮损的间歇期，诊断依赖于通过光试验人工诱发多形性日光疹。光化学疗法（补骨脂素联合紫外线A[PUVA]）是目前一种有效的预防性治疗方法。167例有过多形性日光疹病史或患有现症疾病的患者进入我们的研究。在142例接受检测的患者中，49%在检测部位出现了典型的多形性日光疹皮损。56%的患者其作用光谱在紫外线A范围内，17%在紫外线B范围内，26%在两个范围内。共有122例患者接受了PUVA预防性治疗。其中，51例回来接受随访。在接受随访的患者中，64%报告在夏季户外活动期间得到了完全保护，26%报告得到部分保护，10%未得到保护。疗效未改善与作用光谱无关。我们患者群体的作用光谱和光试验阳性结果的发生率与其他人报告的不同。检测方案和所用光源的差异可能是造成这种差异的原因。显然需要一种标准化的检测程序。然而，大多数患者无论其作用光谱如何，都能从PUVA预处理中获益。
