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.
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。