| Objective:To investigate the efficacy of drug combined moisturizer and sunscreen in the treatment of chronic actinic dermatitis.Methods:From May 2017 to August 2018,216 cases of chronic actinic dermatitis admitted to the department of dermatology of the first affiliated hospital of kunming medical university were divided into 4 groups.The 54 cases of control group was treated by oral administration of ebaxtin discontinued and hydroxychloroquine sulfate tablets for 4 weeks.The external use of Desonide cream for 2 weeks.On this basis,the 56 cases of first treatment group used topical moisturizer twice a day,and topical sunscreen once a day.On this basis,only topical moisturizer was used in 54 cases of second treatment group,twice a day.On this basis,the 52 cases of third treatment group only used topical sunscreen once a day.Patients were followed up at 2,4 and 6 weeks before and after treatment,respectively,through eczema area and severity index to evaluate curative effect,and testing of the four groups of patients’ skin lesions water,trans epidermal water loss and content of lipid,and reflective confocal microscope to observe the inflammatory reaction,blood vessels in skin lesions and so on.Results:After 6 weeks treatment,the efficacy rate of 54 cases in the first treatment group(85.2%)was significantly higher than that of 56 cases in the second treatment group(62.5%),54 cases in the third treatment group(64.8%),52 cases in the control group(50.0%),and the difference was statistically significant(P<0.05).Non-invasive skin test results showed that the trans epidermal water loss of the three groups was 16.42±8.64,21.59±12.34,19.79±11.79,which was significantly lower than that before treatment(38.76±12.59,38.37± 14.48,39.2± 13.93).and the skin water content(42.15±10.25,35.5±12.91,33.42± 12.83)and lipid content(37.96±11.16,31.5±8.31,34.09±12.51),compared with the pre-treatment skin water content(21.30±11.04,16.86±10.88,14.73± 12.00)and lipid content(13.64± 10.10,15.67±12.60,9.42±7.75)significantly increased,the difference was statistically significant(P<0.05).Compared with the second treatment,the third treatment and control group,trans epidermal water loss in the first treatment was significantly decreased,and epidermal water content and lipid content were significantly increased,with statistically significant difference(P<0.05).Reflective confocal microscope:the improvement of spongiosis(0.97±0.68),disruption of honycomb patternand(0.82±0.77)and vascular dilatation(1.03±0.73)under reflective confocal microscope was better in first treatment than that in the second treatment(1.51±0.56,1.0±0.77,1.31 ±0.68).)and the third treatment(1.35±0.85,1.35 ± 0.85,0.97 ± 0.80),the control group(1.85± 0.74,1.85±0.74,1.53±0.61),the difference was statistically significant(P<0.05).Subjective evaluation of patients:pruritus scores in the first treatment compared with the second treatment,and the third treatment and the control group decreased,the difference was statistically significant(P<0.05).Conclusions:The efficacy of drugs combined of moisturizer and sunscreen in the treatment of chronic actinic dermatitis is significantly better than that of simple drug therapy and drugs with topical moisturizer or sunscreen.It suggests that in the treatment of chronic actinic dermatitis,it is not only necessary to be anti-inflammatory,anti-photosensitive treatment,but also need to pay attention to moisturize and sun protection. |
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