| [Objective]1.To take adantage of the high prevalence of chronic actinic dermatitis (CAD) in Yunnan province, to measure and analysis the difference of the minimal erythema dose and photopatch testing between CAD patients and normal individuals, and to investigate the association of inerleukin-6(IL-6),inerleukin-8(IL-8inerl), eukin-10(IL-10),inerleukin-12(IL-12) and inerferon-gamma(IFN-y) with CAD.2.To evluate the efficacy and the mechanism of narrow band ultraviolet B in the treatment of CAD.[Methods]1.The minimal erythema dose (MED) of70patients with CAD and73normal controls were measured by SUV1000type ultraviolet sim ulator. Photopatch test was performed on35patients with CAD and32normal controls with standard photopatch test kit, then they were irradiated by SS-03AB type ultraviolet phototherapy instrument. The ultraviolet A (5J/cm2) was used as the source of irradiation. The serum levels of IL-6, IL-8, IL-10, IL-12and IFN-y of patients with CAD and normal controls were tested by ELISA.2. Six stable patients with CAD were treated every other day by Waldmann UV100L half tank treatment systems. Six patients were treated with0.1%mometasone furoate cream. The medications were applied topically to the lesions on the face twice a day. After four weeks, curative effect and side effect of treatment to determine. The serum levels of IL-6, IL-8, IL-10, IL-12and IFN-y of patients with CAD were tested by ELISA before and after treatment.[Results]1.The MED-ultraviolet A (UVA) and MED-ultraviolet B (UVB) of patients with CAD were26.49J/cm2and40.51mJ/cm2respectively. In the normal controls, the UVA-MED and UVB-MED were45.84J/cm2and44.73mJ/cm2respectively. The UVA-MED and UVB-MED of patients with CAD were significantly less than that of normal controls (P<0.05). The UVA-MED and UVB-MED of normal control and the patients with CAD have no significant differerce between type â…¢ skin and type â…£ skin. In the normal controls, the UVB-MED of men were higher than that on women (P<0.05).The difference was significant.2. The photopatch test result showed that the positive rates were60%and37.5%in the CAD patients and the normal controls respectively. The positive rate in the CAD patients is higher than that of the normal controls. The most common photoallergens of CAD were fragrance mixture (12.5%), chlorhexidine gluconate (10%) and wood composites,4chloro salicylic anilide,6-methylcoumarin and triclosan (7.5%respectively) in that order. In the normal controls, the most common photoallergens were fragrance mixture (29.41%), balsam of Peru(17.65%) and D-usnic acid(11.76%) in that order.3.The serum level of IL-6,IL-8,IL-10,IL-12and IFN-y in patients with CAD were higher than that of the normal controls. The differences of IL-6and IL-8between the two groups were significant(P<0.05). But the differences of IL-10, IL-12and IFN-y between the two groups were no significant.4. The therapeutic success rates in the NB-UVB treatment group and the positive control group were both100%. There is no statistically significant difference between the two groups (P>0.05). There is no side effect in the NB-UVB treatment group. One patient has the side effect of thinning skin and hyperpigmentation in the positive control group. The serum levels of IL-6,IL-8,IL-10,IL-12and IFN-y in CAD patients were decreased after the treatment with NB-UVB.The difference was significant(P<0.05). [Conclisions]1.The MED test shows that the ultraviolet A and ultraviolet B radiation may play roles in the pathogenesis of CAD, which is more sensitive to UVA.2. The photopatch test show that positive reactions for a variety of allergens in CAD patients and healthy controls.3. The higher level of IL-6, IL-8may play a role in the pathogenesis of CAD.4. NB-UVB phototherapy is effective in the treatment of chronic actinc dermatitis. It can potentially be a steroid sparing equivalent on nonacute stage.The pathogenesis of NB-UVB in the treatment of CAD may be associated with regulating the secretion of IL-6, IL-8, IL-10, IL-12and IFN-y. |
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