The Clinical Analysis Of Chronic Actinic Dermatitis

ObjectiveTo analyse the predisposing factors,clinical features and problems of prevetion and treatment in patients with chronic actinic dermatitis (CAD). To identify the Pathogenic spectrum and common Photoallergens of patients with CAD.Then to explore the effective methods of prevention and therapy.Methods196CAD patients between February2006to February2014were enrolled in our study, who were from the ward of the first affiliated hospital of Kunming medical university.94patients for minimal erythema dose (MED) in February2007to February2014in our hospital were analyzed. Clinical data of50CAD in June2012to July2013in our hospital were analyzed, who were performed Photopatch tests using European standard photoallergens.Results1、The results presented here have shown that94patients with MED, UVA-MED reduced is77cases (81.91%), UVB-MED reduced is76cases (80.85%), only UVA-MED reduced is14cases (14.89%), only UVB-MED reduced is13cases (13.83%), both UVA-MED and UVB-MED reduced is63cases (67.02%), there was no response for UVA and UVB in4cases (4.26%).2、In the50patients with CAD,33cases (66%) have one or more positive photoallergens for photopatch test. The frequency of the positive photoallergens in CAD were tetrachloro salicylanilide(TCS) ranked the first, followed by balsam of Peru (BOP),6-methyl coumarin(6-MC), promethazine hydrochloride and chlorpromazine(CPZ).3、196patients, male:female=18.6:1, among those aged over40is180cases (91.84%).The skin lesions of all patients were located in exposed parts of the first episode, some patients with non-exposed parts also appear.The skin lesions of175patients (89.29%) may induce or aggravate after sun exposure.4、90cases of PD pathology phase,4cases of AR phase.5、All patients were given topical corticosteroids and calcineurin inhibitors, supplemented moisturizer. Thickened lesions with lichenoid papules,plaques and nodules to give the packet after local medicine or injection of lesions. All patients with oral antihistamines, supplemented B vitamins,β-carotene. According conditions, treatment with glycyrrhizin, hydroxychloroquine, thalidomide, corticosteroids or immunosuppressants.6、93patients were given phototherapy.7、Patients were given certain psychological counseling and a detailed knowledge of specific health education.ConclusionThe study presented here demonstrated that UVB and UVA plays an important role in the pathogenesis of CAD,they both can be a single cause of CAD.The proportion with abnormal UVA closes to UVB. The TCS, BOP,6-MC,promethazine hydrochloride and CPZ were the most common photoallergens in CAD. Photosensitive material and UVR is closely related to CAD. The clinical features of CAD is consistent with the literature. Avoiding light exposure,removing photosensitive materials,topical corticosteroids, calcineurin inhibitors,supplemented moisturizer and sunscreen are effective. Treatment with systemic hydroxychloroquine, thalidomide and glycyrrhizin are effective. Corticosteroids, immuno-depressive drug resulted in satisfactory effect in some advanced cases. Phototherapy can effectively control CAD.The patient must be given certain psychological counseling, to give a detailed knowledge of specific health education...