| Objective(s):We seek to determine whether there are differences in the general conditions,disease characteristics,family status,lifestyle,going out habits,psychological characteristics,DLQI score characteristics of patients with chronic actinic dermatitis(CAD)and people with healthy skin in Yunnan Province and find out disease risk factors and protective factors,and develop long-term,reliable and effective disease management plans.We seek to determine the efficacy of NB-UVB therapy combined with traditional therapy(desloratadine,thalidomide,hydroxychloroquine,steroid cream)in the treatment of chronic actinic dermatitis(CAD).Methods:1.Questionnaire survey: We designed a questionnaire and informed consent form,including basic information of patients with chronic actinic dermatitis,disease-related content,family survey,living habits,skin care habits,going out habits,psychological survey,DLQI score.We communicated with the experimental group(chronic actinic dermatitis patients)and the control group(skin healthy people)about the content and purpose of the study with the eligible subjects in,and assisted in completing the questionnaire after obtaining the consent.2.NB-UVB treatment: Collect,summarize and analyze the data of gender,age,times of NB-UVB treatment,percentage of skin lesion regression,and side effect of patients receiving conventional therapy plus NB-UVB treatment(experimental group)and conventional therapy(control group).Results:1.Questionnaire survey:153 patients(experimental group)and 153 healthy skin individuals(control group)were investigated.The proportion of male patients was 77.78%,with an average age of 51 years.Hypertension accounted for 45.45% of the population with chronic diseases,79.31% of patients used medication to control chronic diseases,62.74% of patients smoked,and 48.38% of patients drank alcohol.Eczema type patients accounted for 36.60%,98.69% of patients had the onset site at the exposure site,and all patients had the initial onset site at the exposure site.51.81% of patients had the initial onset season in summer,48.54% of patients had the onset season in summer,58.66% of patients had the exacerbation season in summer,and 32.14% of patients had been treated with hormones in the past.26.14% of patients had been diagnosed with eczema in the past,and 51.63% of patients had a history of exposure to photosensitive substances,Food photosensitive substances accounted for 20.00%.The average age of the patient at the first onset of the disease was 45 years old,with an average of 4.0 hours of exposure to sunlight before onset,3.4 hours of exposure to sunlight after onset,and an average of 5.2 hours of outdoor time.52.29% of patients used cleaning agents,68.63% of patients did not use moisturizing skincare products,60.13% of patients did not use sun protection measures,54.12% of patients had low sun protection levels,58.33% of patients were outdoor workers,65.36% of patients worked every day,and 65.57% of patients had outdoor exercise habits.93.46% of patients sought medical attention from specialized physicians,72.41% of patients were dissatisfied with the doctor’s treatment in the past year.The biggest reason for dissatisfaction was poor disease control,41.18% of patients believe that the disease has a significant impact on work and life,28.10% of patients chose a career due to the disease,11.76% wanted to change careers due to the disease,and 34.64% of patients felt frustrated,anxious,and sleep disorders due to the disease,45.10% of patients believed that the most serious problem caused by this disease was sleep,while69.07% of patients learned about this disease through their own medical staff and hospitals.50.98% of patients’ skin quality of life was severely affected.The experimental group and control group showed statistical differences in "education"(X2=20.937,P<0.01).The difference in "smoking" was statistically significant(X2=20.937,P<0.01),the difference in "cleaning agent use" was statistically significant(X2=26.879,P<0.01),the difference in "moisturizing and skincare product use" was statistically significant(X2=25.276,P<0.01),and the difference in "sunscreen measures" was statistically significant(X2=13.242,P<0.01),The differences were statistically significant in the "work environment"(X2=14.548,P<0.01),statistically significant in the "work frequency"(X2=43.897,P<0.01),and statistically significant in the "exercise frequency"(X2=45.208,P<0.01).The impact of exposure history to photosensitive substances on CAD was statistically significant(OR=0.620,95% CI 0.470-0.817,P<0.01),the impact of cleaning agent use on CAD was statistically significant(OR=3.335,95% CI 1.870-5.949,P<0.01),and the impact of moisturizing skincare products on CAD was statistically significant(OR=1.736,95% CI 1.273-2.366,P<0.01),The use of sunscreen measures had a statistically significant difference in the impact on CAD(OR=0.533,95% CI 0.385-0.737,P<0.01),while smoking had a statistically significant difference in the impact on CAD(OR=1.531,95% CI 1.090-2.150,P<0.05).Multiple comparisons found that there was a statistically significant difference in whether the mixed and erythematous groups were exposed to cleaning agents(X2=7.117,P=0.008<0.0125),and mixed type patients tended to use more cleaning agents,Multiple comparisons revealed statistical differences in DLQI levels between the mixed type and erythematous type groups(X2=11.643,P=0.009<0.0125),and erythematous type patients were more likely to have an impact on their quality of life.2.NB-UVB treatment results:The overall difference in efficacy between the experimental group and control group was statistically significant(X2=8.723,P<0.05).The average number of effective CAD exposures is 15.Conclusion(s):1.1 Patient situationThe average age of CAD patients in Yunnan region was 51 years old,with the majority being male and outdoor professionals.Most patients had a low level of education.A small number of patients had a history of chronic diseases,with hypertension accounting for the highest proportion.Most patients had a habit of smoking,while a few had a habit of drinking alcohol.The most common skin lesions in CAD patients were eczema type.Most of the patients had their onset at the exposed site,and all patients had their initial skin lesions at the exposed site.The first onset season,the current onset season,and the worsening season of the disease were mostly in summer,with a relatively small proportion in other seasons,but they could all occur.Most patients had been treated with hormones and antihistamines.CAD may be related to atopic constitution.The average onset age of the patient was 45 years old,and the average exposure time to sunlight decreases after onset.Most CAD patients had clear experience of exposure to photosensitive substances before onset,with food being the most common source of exposure to photosensitive substances.Most patients used clean water as a cleaning agent,did not use moisturizing skincare products,did not use sun protection measures,and had low sun protection levels.Patients hardly used cosmetics.Physical sunscreen accounted for the largest proportion of sunscreen measures.Most patients had good drinking habits.The average length of time for CAD patients in Yunnan was longer,with a higher frequency of work and exercise outside.The psychology of most CAD patients had been greatly affected.More than 80% of CAD patients had a moderate or higher impact on their quality of life.Mixed type patients used more cleaning agents than erythema type patients.Patients with erythema were more likely to have an impact on their quality of life compared to mixed type patients.1.2 Comparison of patients with healthy skinCAD Patients had a lower level of education than the skin healthier.More patients had a history of exposure to photosensitive substances than the skin healthier.Fewer patients used cleaning agents than the skin healthier.Fewer patients used moisturizing skin care products than the skin healthier.Less patients used cosmetics than the skin healthier.More patients tended to choose physical sunscreen methods than the skin healthier.Most patients were outdoor workers than the skin healthier.Patients worked more frequently than the skin healthier.The patient’s exercise frequency was relatively lower than the skin healthier.1.3 Hazardous or protective factorsThe risk factors for CAD include exposure history of photosensitive substances,using sunscreen measures,and smoking.The protective factors for CAD include using detergents,using moisturizing skin care products.In Yunnan and other plateau areas such as Tibet and Qinghai,Doctors should keep follow-up records,actively pay attention to patients’ psychology,and provide comprehensive health education to patients.doctors should recommend that patients avoid exposure to photosensitive substances as much as possible,and reduce the use of soap based detergents,and increase the use of synthetic detergents and strengthen skin moisturizing and strengthen sunscreen measures and select appropriate sunscreen targeted,and quit smoking.3.NB-UVB treatmentFor chronic actinic dermatitis,NB-UVB treatment can be used as a long-term adjuvant program for conventional therapy. |
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