| Chronic actinic dermatitis(CAD)is a disease characterized by chronic photosensitivity induced by sunlight or other light.Its pathogenesis is not yet clear.This study aims at minimal erythema dose and spot of CAD patients and normal people in our city the patch test was determined and analyzed,to explore the relationship between serum levels of IL-8,TNF-alpha and ICAM-1 and the pathogenesis of CAD,and observe the clinical therapeutic effect of hydroxychloroquine in the treatment of CAD,to explore the mechanism of action of hydroxychloroquine in the treatment of CAD.From February 2016 to May 2018,48 patients from the Department of Dermatology of First Affiliated Hospital of Hebei North University outpatient CAD patients and 50 healthy subjects as control group,determine the minimum erythema dose of 48 CAD patients and 50 normal controls using the Waldmann solar simulator,and the German Waldmann type ultraviolet phototherapy instrument and standard photopatch test kit,48 patients with CAD and 50 normal controls were photopatch tests(UVB5J/cm2 source).The serum levels of IL-8,TNF-,and s ICAM-1 were detected by ELISA in 48 patients with CAD and 50 normal controls.According to the photopatch test results of 48 CAD patients were divided into PPT positive group and PPT negative group,random PPT positive group and PPT negative group were divided into treatment group and control group.The treatment group was treated with hydroxychloroquine 200mg/d QD,the control group was given 10mg/d QD,serum IL-8,TNF-and ICAM-1 levels after 48 D treatment.Lack of treatment 48 D cured,48 days after the detection,and again observed minimal erythema dose of.The spss20.0 was used to analyze the test data.The results show that:(1)in the group of CAD UVA-MED,UVB-MED 27.65J/cm2 and 42.50J/cm2 respectively;normal control group UVA-MED,UVB-MED were 40.01J/cm2,46.39J/cm2 and UVB-MED UVA-MED;CAD group were lower than the normal control group(P < 0.05),the difference was statistically significant;no statistically significant group of patients with CAD type III skin and type IV skin UVA-MED difference(P > 0.05),CAD group of patients with type III skin UVB-MED was lower than that of type IV skin(P < 0.05),the difference was statistically significant;the normal control group of different skin type between UVA-MED and UVBMED had no significant difference(P > 0.05);normal control group is lower than that of UVA-MED type III skin type IV skin(P < 0.05),the difference was statistically significant,the normal type of group III and IV type UVBMED skin skin were not obvious(P > 0.05);CAD group of male UVA-MED is lower than that of normal control The difference of the group was statistically significant(P < 0.05).(2)22 cases of 48 patients with CAD PPT positive,26 PPT negative patients,the positive rate was 46%,common photoallergens: aromatic compounds accounted for(28.35%),a mixture of wood(19.5%),novex(10%),diphenhydramine(10%),Peru(5%),its three balsam anilic(5%),6-(4%,six)methylcoumarin chlorphenol(4%)and usnic acid.50 cases of normal control group,16 cases were PPT positive,34 PPT negative patients,the positive rate was 32%,the common photoallergens aromatic mixture(20.15%),a mixture of wood(9.5%),the double sulfur sulfur powder(10%),atranorin(10%),6-methyl coumarin(9.5%),Peru balsam(9.15%),four chloro salicylanilides(8%)etc..(3)the effective rate of hydroxychloroquine in patients with PPT negative CAD and PPT positive treatment group was 100% and 75% respectively,and the difference was statistically significant(P > 0.05).Hydroxychloroquine treatment group PPT negative CAD patients and PPT positive control group were significantly higher than that of loratadine group(P < 0.05),the difference was statistically significant;hydroxychloroquine treatment group after treatment of cytokines IL-8,TNFalpha and s ICAM-1 were lower than those before treatment(P < 0.05),the difference was statistically significant.After treatment,UVA-MED and UVB-MED were higher than the loratadine control group(P<0.05)after treatment in the hydroxychloroquine group.The results suggested that:(1)UVA-MED and UVB-MED in CAD patients were lower than those of normal controls,suggesting that UVA and UVB exposure were associated with the pathogenesis of CAD.(2)the positive rate of light contact allergens in CAD patients was significantly higher than that in the normal control group,suggesting that light exposure to allergens is one of the causes of the pathogenesis of CAD.(3)the incidence of CAD has a certain relationship with the increase of IL-8,TNFalpha and s ICAM-1.The mechanism of 4.hydroxychloroquine in the treatment of CAD may be related to the regulation of the secretion of IL-8,TNF-alpha and s ICAM-1. |
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