慢性光化性皮炎发病机制及治疗 |
| 孙思昊，李 晔，农 祥 ，何 黎 |
| 昆明医科大学第一附属医院皮肤科，云南 昆明 650032 |
The mechanism and treatment of chronic actinic dermatitis |
| SUN Si-hao,LI Ye,NONG-Xiang ,HE-Li |
| The First Affi liated Hospital of Kunming Medical University,Kunming,Yunnan 650032,China |
| 摘要 |
[目的] 慢性光化性皮炎是与日光照射高度相关的慢性光敏性皮肤病，发病机制暂未完全明确，当前普遍认为与紫外线引起的迟发性超敏反应、免疫功能紊乱及炎症反应相关。治疗主要使用预防措施及局部使用糖皮质激素为主，对急性期及重型患者也可使用硫唑嘌呤、环孢素及羟氯喹等进行治疗。可通过手术治疗达到对皮肤外观有严格要求者的期望。 |
| 关键词 |
慢性光化性皮炎 ; 发病机制 ; 紫外线 ; 免疫反应 ; 治疗 |
| Abstract： |
Chronic actinic dermatitis is a chronic photosensitive skin disease that is highly related to sunlight. The pathogenesis is not yet fully under-stood. It is currently generally believed to be related to delayed hypersensitivity, immune disorder and infl ammation caused by ultraviolet rays. The cur-rent fi rst-line treatment mainly uses preventive measures and topical glucocorticoids, but acute and severe patients can also be treated with azathioprine,cyclosporine, and hydroxychloroquine. Surgical treatment can meet the expectations of those who have strict requirements on the appearance of the skin. |
| Keywords |
Chronic actinic dermatitis ; Pathogenesis ; Ultraviolet ; Immune response ; Treatment |
| 参考文献 |
［1］ Somani V K.Chronic actinic dermatitis--a study of clinical fea-tures[J].Indian journal of dermatology[J].venereology and leprolo-gy,2005,71(6):409-413.
［2］ Lugović M L,Bulat V,Situm M,et al.Allergic hypersensitivityskin reactions following sun exposure[J].Collegium antropologi-cum,2008,32(Suppl 2):153-157.
［3］ 李俞晓 , 农祥 , 何黎 , 等 . 慢性光化性皮炎及多形性日光疹 102 例光斑贴试验分析 [J]. 临床皮肤科杂志 ,2014,43(10):598-600.
［4］ Fujii S,Washio K,Masaki T.Case report of chronic actinic dermatitisaccompanied by ultraviolet A photosensitivity in a Chrysanthemumfarmer[J].The Journal of dermatology,2019,46(7):e29-e30.
［5］ Ko D Y,Choi S H,Ha S M,et al.The clinical severity score of chronicactinic dermatitis correlates with in vivo photoallergic reactions andthe immunologic parameters related to a shift towards Th 2 immuni-ty from the Th 2 /Th 1 balanced status in patients with chronic actinicdermatitis[J].Photodermatology,photoimmunology&photomedi-cine,2016,32(4):199-206.
［6］ Tan K W,Haylett A K,Ling T C,et al.Comparison of Demograph-ic and Photobiological Features of Chronic Actinic Dermatitis inPatients With Lighter vs Darker Skin Types[J].JAMA dermatolo-gy,2017,153(5):427-435.
［7］ Kim H J,Kim K H.Increased incidence of chronic actinic dermatitisin relation to climate changes and air pollution during the past 15years in Korea[J].Photodermatology,photoimmunology&photomedi-cine,2018,34(6):387-392.
［8］ Hu S C,Lan C E.Tungsten lamp and chronic actinic dermatitis[J].TheAustralasian journal of dermatology,2017,58(1):e14-e16.
［9］ Mohania D,Chandel S,Kumar P,et al.Ultraviolet Radiations:Skin De-fense-Damage Mechanism[J].Advances in experimental medicine andbiology,2017(996):171-187.
［10］ Prue H H,Mary N,Scott N B,et al.Exposure to Ultraviolet Radiationin the Modulation of Human Diseases[J].Annual review of patholo-gy,2019(14):55-81.
［11］ Narita K,Asano K,Morimoto Y,et al.Chronic irradiation with 222-nm UVC light induces neither DNA damage nor epidermal lesions inmouse skin,even at high doses[J].PloS one,2018,13(7):e0201259.
［12］ Dongyun L,Lechun L,Li Y,et al.Genome-Wide Analysis of mRNAand Long Noncoding RNA Profi les in Chronic Actinic Dermatitis[J].BioMed Research International,2017(2017):7479523.
［13］ Alafi atayo A A,Lai K S,Ahmad S,et al.RNA-Seq analysis revealedgenes associated with UV-induced cell necrosis through MAPK/TNF-α pathways in human dermal fi broblast cells as an inducer ofpremature photoaging[J].Genomics,2020,112(1):484-493.
［14］ Wolf S J,Estadt S N,Gudjonsson J E,et al.Human and Murine Ev-idence for Mechanisms Driving Autoimmune Photosensitivity[J].Frontiers in immunology,2018(9):2430.
［15］ Wang P W,Hung Y C,Lin T Y,et al.Comparison of the BiologicalImpact of UVA and UVB upon the Skin with Functional Proteom-ics and Immunohistochemistry[J].Antioxidants(Basel,Switzer-land),2019,8(12):569.
［16］ Kim J M,Kim S Y,Noh E M,et al.Reversine inhibits MMP-1 andMMP-3 expressions by suppressing of ROS/MAPK/AP-1 activationin UV-stimulated human keratinocytes and dermal fi broblasts[J].Ex-perimental dermatology,2018,27(3):298-301.
［17］ IShitsuka Y,Roop D R.Loricrin Confers Photoprotective Functionagainst UVB in Corneocytes[J].The Journal of investigative derma-tology,2018,138(12):2684-2687.
［18］ Marsella R,Papastavros V,Ahrens K,et al.Decreased expression ofcaspase-14 in an experimental model of canine atopic dermatitis[J].Veterinary journal (London,England:1997),2016(209):201-203.
［19］ Nagahara Y.Sphingoid Base-Upregulated Caspase-14 ExpressionInvolves MAPK[J].Regular Article,2018,41(5):743-748.
［20］ Ten B O,Van W H,Bruijnzeel K C A F M,et al.Throwing a light onphotosensitivity in atopic dermatitis: a retrospective study[J].Ameri-can journal of clinical dermatology,2009,10(2):119.
［21］ Quatrano N A,Shvartsbeyn M,Meehan S A,et al.Chronic actinic der-matitis occurring in an adult with atopic dermatitis[J].Dermatologyonline journal,2015,21(12):19.
［22］ Moyal D D,Fourtanier A M.Broad-spectrum sunscreens provide betterprotection from solar ultraviolet-simulated radiation and natural sun-light-induced immunosuppression in human beings[J].Journal of theAmerican Academy of Dermatology,2008,58(5 Suppl 2):S149-154.
［23］ Monseau A J,Reed Z M,LANgley K J,et al.Sunburn,Thermal,andChemical Injuries to the Skin[J].Primary care,2015,42(4):591-605.
［24］ Rabinovich L,Kazlouskaya V.Herbal sun protection agents:Humanstudies[J].Clinics in dermatology,2018,36(3):369-375.
［25］ Berman B,Ellis C,Elmets C.Polypodium Leucotomos--An Overviewof Basic Investigative Findings[J].Journal of drugs in dermatology:JDD,2016,15(2):224-228.
［26］ Bhari N,Gupta S.Tacrolimus 0.1% ointment applied under oc-clusion using cling film clears chronic actinic dermatitis resis-tant to systemic treatment[J].International journal of dermatolo-gy,2017,56(6):e139-e141.
［27］ Ma Y,Lu Z.Treatment with topical tacrolimus favors chronic actinicdermatitis:a clinical and immunopathological study[J].The Journal ofdermatological treatment,2010,21(3):171-177.
［28］ Zduńska K,Dana A,Kolodziejczak A,et al.Antioxidant Properties ofFerulic Acid and Its Possible Application[J].Skin pharmacology andphysiology,2018,31(6):332-336.
［29］ Lahouel M,Ben kahlA M,Aounallah A,et al.Severe chronic actinicdermatitis treated successfully with Thalidomide[J].Photodermatolo-gy,photoimmunology&photomedicine,2020,36(6):493-495.
［30］ Gozali M V,Zhou B R,Luo D.Update on treatment of photodermato-sis[J].Dermatology online journal,2016,22(2):2.［31］ Dawe R S,Ferguson J.Diagnosis and treatment of chronic actinicdermatitis[J].Dermatologic therapy,2003,16(1):45-51.［32］ Nahhas A F,Oberlin D M,Braunberger T L,et al.Recent Developmentsin the Diagnosis and Management of Photosensitive Disorders[J].American journal of clinical dermatology,2018,19(5):707-731.［33］ Vesely M D,IMaeda S,King B A.Tofacitinib citrate for the treatmentof refractory,severe chronic actinic dermatitis[J].JAAD case re-ports,2017,3(1):4-6.［34］ Verma L,Pratt M.A case report of therapeutically challeng-ing chronic actinic dermatitis[J].SAGE open medical case re-ports,2019(7):2050313X19845235.［35］ Jiang A J,Lim H W.Phototherapy in the Evaluation and Managementof Photodermatoses[J].Dermatologic clinics,2020,38(1):71-77.［36］ Chee S N,Novakovic L,Fassihi H,et al.Chronic actinic dermatitis:-successful treatment with psoralen-ultraviolet A photochemothera-py[J].The British journal of dermatology,2018,178(3):e189-e190.［37］ Ma L,Zhang Q,Hu Y,et al.Evaluation of narrow band ultraviolet Bphototherapy in the treatment of chronic actinic dermatitis in Chinesepatients[J].Dermatologic therapy,2017,30(6):12528.［38］ Reichenberger M A,Stoff A,Richter D F.Surgical management ofchronic actinic dermatitis[J].Journal of plastic,reconstructive&aes-thetic surgery:JPRAS,2008,61(9):e11-14.
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