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Objective To investigate the optimal regimen of narrow-band ultraviolet B (NB-UVB) phototherapy in the treatment of chronic actinic dermatitis (CAD),and to analyze factors influencing treatment compliance.Methods Demographic data,results of photobiological tests,treatment parameters and clinical responses were collected from CAD patients who received NB-UVB phototherapy in Huashan Hospital affiliated to Fudan University from January 2008 to June 2015,and were reviewed retrospectively.Statistical analysis was done by using two independent samples t-test and chi-square test with SAS9.3 software to compare the clinical data between patients who completed and did not complete the NB-UVB phototherapy.Results A total of 79 CAD patients with Fitzpatrick skin type Ⅳ received NB-UVB phototherapy.Of these patients,61 (77％) completed the whole treatment,while 18 (23％) dropped out because of intolerance to the NB-UVB radiation.Among the 61 patients who completed the treatment,the average initial,final and cumulative radiation doses of NB-UVB were (0.08 ± 0.01) J/cm2,(0.32 ± 0.08) J/cm2and (5.9 ± 2.5) J respectively,and patients received (28 ± 8) times of treatment in average.When the radiation dose went up to 0.30 J/cm2,most skin lesions were cleared in 52 (85％) patients.A total of 19patients received phototesting again after the end of phototherapy.Among 16 patients sensitive to ultraviolet A (UVA) before the treatment,6 had normal minimal erythema dose to UVA (UVA-MED),and another 6 had improved UVA-MED after the treatment.Among 16 patients sensitive to UVB before the treatment,11 got normal UVB-MED and another 3 had improved UVB-MED after the treatment.Univariate analysis showed no significant differences in gender,age,duration of the disease,sensitivity to UVA and UVB radiation,results of photopatch test and patch test between the patients who completed and did not complete the treatment (all P ＞ 0.05).Conclusions The appropriate NB-UVB phototherapy for CAD patients should start at an initial radiation dose of 0.08 J/cm2 in spring and end at a final radiation dose of 0.30 J/cm2 for about 28 sessions,which can effectively reduce the photosensitivity to both UVA and UVB in CAD patients.Additionally,NB-UVB phototherapy can be applied in CAD patients of different gender,age,disease duration and photosensitive condition.
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Objective To study the influence of sunscreens with different efficacy on delayed type hypersensitivity (DTH) and their immunoprotective effect in mice.Methods A cohort of mice were randomly divided into 5 groups with 10 mice in each group:group 1 as the positive control without irradiation,group 2 receiving solar-simulated radiation (SSR) only,group 3 receiving SSR and protected by sunscreen l with sun protection factor 15(SPF15)and persistent pigment darkening(PPD)12,group 4 receiving SSR and protected by sunscreen 2 with SPF 50 and PPD 28,and group 5 as the negative contml receiving SSR only.SSR was carried out on the back of mice with the UVA dose being 1.4 J/cm2 and UVB dose being 100 mJ/cm2 for 10 days.After a 5-day irradiation,the groups 1 to 4 were immunized by intraperitoneal injection with 100 μl(107 cells/ml) of Candida albicans suspension.On the 10th day both sides of the posterior foot pad were measured;then the foot pads were injected with additional 50 μl of the Candida albicans suspension.Twenty-four hours after the injection,the thickness of each foot pad was measured,and immunosuppression rate was calculated.Finally,the mice were sacrificed and skin samples were obtained from the back of these mice followed by the examination of CDla, CD80 and CD86 expression by Western blot.Resets The thickness of edema in foot pads was 0.41±0.38 mm,0.21±0.23 mm and 0.30 ± 0.25 mm in group 1,3 and 4,respectively,significantly higher than in group 5 and 2(0.04±0.03 mm,0.14±0.12 mm,respectively,all P0.05).Significant differences were observed in the immunosuppression rate between group 2,3 and 4(73.0%±11.3%,54.1%±6.4%,29.7%±7.5%,respectively,all P0.05).Conclusions The exposure to sub-erythema dose of UV can induce DTH,and sunscreens have an immunoprotective effect in this process.Epidermal Langerhans cells are not essential for UV-induced immunosuppression.
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Objective To study the efficacy and mechanism of compound Tripterygium hypoglaucum Hutch (THH) on photoallergic contact dermatitis in mice. Methods The photoallergic animal model of BALB/c mice was established by using photosensitizer chlorpromazine and UVA irradiation. The therepeutic efficacy was determined by measuring the thickness and the weight of the swelling ear and the number of infiltrated mononuclear cells in the ear tissue. Immunohistochemical technique was used to detect the ICAM-1 expression on keratinocytes, fibroblasts and vascular endothelial cells. The serum level of INF-? was measured by ELISA. The tested animals were divided into 3 groups: compound THH, THH alone and normal saline. Results The difference of the thickness of left ear before and after challenge, the differences of the thickness and the weight of ear tissue, the difference of the number of infiltrated mononuclear cells of left and right ear after challenge were significantly less in the compound THH group than those in the THH alone group (P
ABSTRACT
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.