慢性光化性皮炎常见致敏药物成份分析

Analysis of common pharmaceutial ingredients triggering chronic actinic dermatitis

目的探究光接触性变应原中药物成份在慢性光化性皮炎(chronic actinic dermatitis,CAD)发病中的作用。方法选取2008年5月至2018年5月在复旦大学附属华山医院皮肤科就诊的CAD患者,将679例CAD患者作为CAD组,将421例同期曝光部位无皮炎或湿疹样皮损的其他皮肤疾病患者作为对照组,对其光斑贴试验结果进行分析。结果 CAD组药物成份变应原阳性率高于对照组(P<0.05),常见的变应原依次为氯丙嗪、对氨基苯甲酸和硫柳汞。CAD组中氯丙嗪、四氯水氧酰酰苯胺、三氯生阳性率高于对照组(P<0.05),其中,女性患者氯丙嗪、硫柳汞阳性率明显升高,男性患者氯丙嗪、四氯水氧酰酰苯胺阳性率明显升高(P<0.05)。结论光接触性变应原中的药物成份与CAD发病密切相关。CAD患者应避免接触光斑贴阳性药物及与其存在交叉反应的药物。

Objective To investigate the role of pharmaceutical ingredients in photoallergens in the pathogenesis of chronic actinic dermatitis(CAD). Methods A retrospective analysis was conducted in 679 patients with CAD, compared with 421 patients with no eczema-like lesions on sun-exposed areas, who were photopatch tested in Huashan hospital from May 2008 to May 2018. Results The positive rate of pharmaceutical ingredient allergens in the CAD group was higher than that in the control group(P<0.05). The most commonly positive agents in photopatch test were chlorpromazine, para-aminobenzoic acid and thimerosal. The positive rates of chlorpromazine, tetrachlorosalicylanilide and triclosan in the CAD group were higher than those in the control group(P<0.05). Among them, the positive rates of chlorpromazine and thimerosal were significantly increased in female patients, chlorpromazine and tetrachlorosalicylanilide in male patients, respectively(P<0.05). Conclusion Pharmaceutical ingredients of photoallergens may play important roles in the pathogenesis of CAD. Patients with CAD should avoid exposure to the positive pharmaceutical ingredients in photopatch tests and drugs that can cause cross-reactivity with the ingredients.