慢性光线性皮炎的光斑贴试验和斑贴试验

Photopatch and Patch Testing in Chronic Actinic Dermatitis

目的确定(光)接触性变应原在慢性光线性皮炎(chronicactinicdermatitis,CAD)发病中的作用。方法依照英国光学皮肤病研究组推荐的光斑贴试验方案以及常规斑贴试验方案,以PhilipsTL20W/09N为光源,采用标准光斑贴和斑贴试剂盒,对56例CAD、42例多形性日光疹(polymorphiclighteruption,PLE)和25例头面部慢性湿疹患者进行了光斑贴和斑贴试验。结果56例CAD患者中光斑贴试验阳性26例占46.43%,斑贴试验阳性32例占57.14%,二者均为阳性18例占32.14%,明显高于PLE患者中的相应比率。CAD患者斑贴试验变应原阳性率接近头面部慢性湿疹,且阳性变应原出现频率和次序基本相同,依次为芳香混合物、秘鲁香脂、对苯二胺、氯化钴和硫酸镍。CAD中最常见的变应原为芳香混合物和秘鲁香脂,两者占斑贴试验阳性反应的百分数分别为44%和32%,光斑贴试验则分别为15.38%和17.95%。结论(光)接触性变应原与CAD发病密切相关。CAD患者应避免接触斑贴和光斑贴试验中呈阳性反应的变应原及其可引起交叉反应的相关化合物。

Objective To study the role of photoallergens and contact allergens in the pathogenesis of chronic actinic dermatitis (CAD).Methods Ba sed on the standard procedures of photopatch test recommended by the British Pho todermatology Group (BPG) and the routine procedures of patch test,photopatch a nd patch tests were performed on 56 patients with CAD,42 patients with polymorp hous light eruption (PLE) and 25 patients with chronic eczema on scalp and face by standard photopatch test series recommended by the International Contact Derm atitis Research Group (ICDRG) and home-made standard series of contact allerge ns.A set of ten Philips TL20W/09N tubes was used as the source of irradiation.Results In the 56 CAD patients,the positive rates were 46.43 %,57.14 % and 32.14% for photopatch test,patch test and both tests,respectively,which appea red to be significantly higher than those in the patients with PLE.Positive pa tch reactions were found in 65% of the patients with chronic eczema,which was s imilar to that of CAD.And the frequency of the positive allergens in chronic ec zema was the same as that in CAD,in which fragrance mixture (FM) ranked the fir st,followed by balsam of Peru (BOP),cobalt chloride,nickel sulphate.In CAD,FM and BOP were the most common allergens and photoallergens,which accounted fo r 44% and 32% of the positive reactions in patch tests,15.38% and 17.95% in pho topatch tests,respectively.Conclusions Both photoallergens and contact aller gens may play important roles in the pathogenesis of CAD.Allergens positive in patch tests and photopatch tests and related compounds which can cause cross-r eactivity with the above allergens should be avoided by the patients with CAD.