Abstract：
OBJECTIVE: Actinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis that affects high-risk populations. We analyzed the clinical manifestations and onset of actinic conjunctivitis (AC), and its relationship with prurigo (AP) in a susceptible population.
METHODS: This prospective observational cohort study was performed on Indigenous populations from the highlands of Chiapas, Mexico. Thorough dermatological and ophthalmological examinations were performed in patients attending a primary health care center. The clinical features, labor and environmental factors, onset timing, and clinical staging of AC and AP were analyzed.
RESULTS: Of the 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC, and 14 patients (25.9%) had AP. The mean age at diagnosis was 36.18 ± 18.52 years (6-70 years). The mean residential altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 h a day (0.5-12 h). A total of 90.7% reported exposure to biomass fuels during cooking, and 50% to farm animals. AC was the sole manifestation in 70% of the cases. All patients had nasal and temporal photo-exposed conjunctiva. Among the eyes, 12.9% were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. A total of 83.3% of the patients had hyperpigmented lesions, and 35.1% had evaporative dry eye disease.
CONCLUSIONS: AC may be the initial or sole manifestation of AP. Most AC cases (87%) were initially observed at the advanced stages of the disease. Although solar exposure was not associated with late AC stages, a positive association was found with farm animal exposure. Evaporative dry eye associated with meibomian gland dysfunction has not been previously reported in patients with AC.
METHODS: This prospective observational cohort study was performed on Indigenous populations from the highlands of Chiapas, Mexico. Thorough dermatological and ophthalmological examinations were performed in patients attending a primary health care center. The clinical features, labor and environmental factors, onset timing, and clinical staging of AC and AP were analyzed.
RESULTS: Of the 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC, and 14 patients (25.9%) had AP. The mean age at diagnosis was 36.18 ± 18.52 years (6-70 years). The mean residential altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 h a day (0.5-12 h). A total of 90.7% reported exposure to biomass fuels during cooking, and 50% to farm animals. AC was the sole manifestation in 70% of the cases. All patients had nasal and temporal photo-exposed conjunctiva. Among the eyes, 12.9% were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. A total of 83.3% of the patients had hyperpigmented lesions, and 35.1% had evaporative dry eye disease.
CONCLUSIONS: AC may be the initial or sole manifestation of AP. Most AC cases (87%) were initially observed at the advanced stages of the disease. Although solar exposure was not associated with late AC stages, a positive association was found with farm animal exposure. Evaporative dry eye associated with meibomian gland dysfunction has not been previously reported in patients with AC.
摘要：
目标：光化性结膜炎（AC），随着唇炎（AChe），是光化性痒疹（AP）临床谱的一部分，一种影响高危人群的罕见照片皮肤病。我们分析了光化性结膜炎（AC）的临床表现和发作，及其与易感人群中prurigo（AP）的关系。
方法：这项前瞻性观察性队列研究是在恰帕斯州高地的土著居民中进行的，墨西哥。在初级保健中心就诊的患者中进行了全面的皮肤病学和眼科检查。临床特征，劳动和环境因素，发病时间,分析AC和AP的临床分期。
结果：在研究的2913名患者中，54例（108只眼）（1.8%）有AC，14例(25.9%)患者患有AP。诊断时的平均年龄为36.18±18.52岁（6-70岁）。平均居住高度为海拔1884±434.2m。平均自我报告的日晒暴露量为每天5.14±3.1小时（0.5-12小时）。共有90.7%的人报告在烹饪过程中接触生物质燃料，和50％的农场动物。在70％的病例中，AC是唯一的表现。所有患者均有鼻腔和颞部光暴露的结膜。在眼睛中，12.9%被归类为阶段-1，64.8%被归类为阶段-2，22.2%被归类为阶段-3。共有83.3%的患者有色素沉着过度病变,35.1%患有蒸发性干眼病。
结论：AC可能是AP的初始或唯一表现。大多数AC病例（87％）最初是在疾病的晚期阶段观察到的。尽管太阳暴露与晚期AC阶段无关，发现与农场动物暴露呈正相关.先前尚未报道AC患者与睑板腺功能障碍相关的蒸发性干眼。
方法：这项前瞻性观察性队列研究是在恰帕斯州高地的土著居民中进行的，墨西哥。在初级保健中心就诊的患者中进行了全面的皮肤病学和眼科检查。临床特征，劳动和环境因素，发病时间,分析AC和AP的临床分期。
结果：在研究的2913名患者中，54例（108只眼）（1.8%）有AC，14例(25.9%)患者患有AP。诊断时的平均年龄为36.18±18.52岁（6-70岁）。平均居住高度为海拔1884±434.2m。平均自我报告的日晒暴露量为每天5.14±3.1小时（0.5-12小时）。共有90.7%的人报告在烹饪过程中接触生物质燃料，和50％的农场动物。在70％的病例中，AC是唯一的表现。所有患者均有鼻腔和颞部光暴露的结膜。在眼睛中，12.9%被归类为阶段-1，64.8%被归类为阶段-2，22.2%被归类为阶段-3。共有83.3%的患者有色素沉着过度病变,35.1%患有蒸发性干眼病。
结论：AC可能是AP的初始或唯一表现。大多数AC病例（87％）最初是在疾病的晚期阶段观察到的。尽管太阳暴露与晚期AC阶段无关，发现与农场动物暴露呈正相关.先前尚未报道AC患者与睑板腺功能障碍相关的蒸发性干眼。
