Neumann N J, Hölzle E, Lehmann P, Benedikter S, Tapernoux B, Plewig G
Department of Dermatology, Heinrich Heine University, Düsseldorf, Germany.
Photodermatol Photoimmunol Photomed. 1994 Apr;10(2):65-73.
In a multicenter study, photopatch test results from more than 1500 patients were evaluated between 1985 and 1990 and from 614 patients between 1990 and 1992. Photopatch testing was conducted according to a standardized procedure. Nearly half of the photoreactions were unclassifiable according to the classic definitions of photoallergic or phototoxic reactions. To facilitate the interpretation of these remaining photopatch test reactions, we developed a computerized substance specific reaction pattern analysis. By sequential readings from immediately after irradiation up to 72 h later and by morphological qualification of the reactions, the time course and morphological changes of each individual reaction were monitored. The summation of each individual photoreaction resulted in an overall reaction pattern of a specific substance. Four main categories could be distinguished. The first category was characterized by a peak immediately after irradiation followed by a descrescendo reaction. The second category comprized reactions combining an immediate with a delayed reaction. The third category exhibited a plateau-like delayed reaction. The fourth category showed delayed reactions in a crescendo pattern. Whereas category 1 represents classic phototoxic and category 4 classic photoallergic reaction patterns, the underlying mechanisms of categories 2 and 3 remain to be investigated. Typical substances of category 1 were many of the tested systemic drugs, such as furosemide, most of which are well-known phototoxic agents. Disinfectants, nonsteroidal anti-inflammatory agents and phenothiazines showed the reaction patterns of categories 2 and 3. A delayed type reaction (category 4) could be demonstrated for well-known photoallergens such as fenticlor, musk ambrette, and ultraviolet adsorbents in sunscreens.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项多中心研究中，对1985年至1990年间1500多名患者以及1990年至1992年间614名患者的光斑贴试验结果进行了评估。光斑贴试验按照标准化程序进行。根据光变应性或光毒性反应的经典定义，近一半的光反应无法分类。为便于解释这些剩余的光斑贴试验反应，我们开发了一种计算机化的物质特异性反应模式分析方法。通过从照射后立即到72小时后的连续读数以及反应的形态学鉴定，监测每个个体反应的时间进程和形态变化。每个个体光反应的总和产生了一种特定物质的总体反应模式。可区分出四个主要类别。第一类的特征是照射后立即出现峰值，随后是递减反应。第二类包括即时反应与延迟反应相结合的反应。第三类表现出平台样延迟反应。第四类呈现递增模式的延迟反应。虽然第一类代表经典的光毒性反应，第四类代表经典的光变应性反应模式，但第二和第三类的潜在机制仍有待研究。第一类的典型物质是许多受试的全身用药物，如呋塞米，其中大多数是众所周知的光毒性药物。消毒剂、非甾体抗炎药和吩噻嗪表现出第二和第三类的反应模式。对于众所周知的光变应原，如芬替克洛、葵子麝香和防晒剂中的紫外线吸收剂，可表现出延迟型反应（第四类）。（摘要截短于250词）
