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Chen Y, Wu M, Chen L, Li Z, Zhou Z, Li W, Zhang G. ALA-PDT combined with CO 2 laser in the treatment of malignant hidroacanthoma simplex: A case report. Photodiagnosis Photodyn Ther 2024:104299. [PMID: 39089478 DOI: 10.1016/j.pdpdt.2024.104299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/12/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
Hidroacanthoma simplex (HS) is a rare skin appendage tumor that typically appears on the trunk and lower limbs in the elderly. Although HS is a predominantly benign condition, the presence of cellular atypia and dermal infiltration on histological examination indicates malignant HS (MHS). 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) uses a photosensitizer and corresponding light source to cause irreversible damage or death of target cells through a photochemical reaction. Here, we reported the successful treatment of a MHS patient with ALA-PDT using plum-blossom needle pretreatment combined with CO2 laser. After five courses of ALA-PDT, the lesions were completely resolved, and the autonomic activity and smooth surface of the left ring finger were restored. This suggests that ALA-PDT is an effective, minimally invasive and safe treatment modality for MHS.
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Affiliation(s)
- Yulu Chen
- Skin Cancer Center & Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
| | - Mingshun Wu
- Skin Cancer Center & Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
| | - Lianjun Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenlin Li
- Skin Cancer Center & Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
| | - Zhongxia Zhou
- Skin Cancer Center & Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
| | - Wei Li
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Guolong Zhang
- Skin Cancer Center & Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China.
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Nie M, Zhang P, Pathak JL, Wang X, Wu Y, Yang J, Shen Y. Photodynamic therapy in periodontitis: A narrative review. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12946. [PMID: 38288767 DOI: 10.1111/phpp.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Periodontitis, a chronic infectious disease, is primarily caused by a dysbiotic microbiome, leading to the destruction of tooth-supporting tissues and tooth loss. Photodynamic therapy (PDT), which combines excitation light with photosensitizers (PS) and oxygen to produce antibacterial reactive oxygen species, is emerging as a promising adjuvant treatment for periodontitis. METHODS This review focuses on studies examining the antibacterial effects of PDT against periodontal pathogens. It also explores the impact of PDT on various aspects of periodontal health, including periodontal immune cells, human gingival fibroblasts, gingival collagen, inflammatory mediators, cytokines in the periodontium, vascular oxidative stress, vascular behavior, and alveolar bone health. Clinical trials assessing the types of PSs and light sources used in PDT, as well as its effects on clinical and immune factors in gingival sulcus fluid and the bacterial composition of dental plaque, are discussed. RESULTS The findings indicate that PDT is effective in reducing periodontal pathogens and improving markers of periodontal health. It has shown positive impacts on periodontal immune response, tissue integrity, and alveolar bone preservation. Clinical trials have demonstrated improvements in periodontal health and alterations in the microbial composition of dental plaque when PDT is used alongside conventional treatments. CONCLUSIONS PDT offers a promising adjunctive treatment for periodontitis, with benefits in bacterial reduction, tissue healing, and immune modulation. This article highlights the potential of PDT in periodontal therapy and emphasizes the need for further research to refine its clinical application and efficacy.
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Affiliation(s)
- Min Nie
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peipei Zhang
- Department of Oral Medicine, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Janak Lal Pathak
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoyu Wang
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yafei Wu
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingmei Yang
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqin Shen
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
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Gu L, Zhou S, Shi Z, Zhai X, Gu L, Zhou B, Hua H. Peripheral blood CD4 + T cell count predicts recurrence of condyloma acuminatum after photodynamic therapy in HIV-positive patients. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:246-255. [PMID: 36052757 DOI: 10.1111/phpp.12832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 08/03/2022] [Accepted: 08/30/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Few studies have reported postoperative relapse of condyloma acuminatum (CA) after 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in human immunodeficiency virus (HIV) positive patients. METHODS The clinical data of HIV-positive CA patients treated with ALA-PDT from October 2018 to December 2019 were analyzed retrospectively. Univariate and multivariate Cox regression was used to analyze the variables related to postoperative recurrence. Pearson correlation test was employed to analyze the correlation between CD4+ T cell count and postoperative recurrence rate. Kaplan-Meier method was used to compare the CA recurrence after ALA-PDT in low CD4 group and high CD4 group. RESULTS A total of 38 HIV-positive patients with CA were included in the study. Among them, 26 patients experienced CA recurrence within 6 months, and the recurrence rate was 68.4%. CD4+ T cell count was 187.0 (79.0-596.0) cells/μl in relapsed patients and 406.0 (89.0-612.0) cells/μl in non-relapsed patients, showing a statistically significant difference (p = .005). Pearson correlation coefficient analysis revealed a negative correlation between CD4+ T cell count and postoperative recurrence rate (p = .005, r = -.443). Univariate regression analysis showed that CD4+ T cell count was correlated with postoperative recurrence, hazard ratio (HR) was 0.99 [95% Confidence interval (CI) = 0.99-1.0, p = .012]. Multivariate Cox regression analysis showed that with the low CD4+ T cell count as the reference, the high CD4+ T cell count was negatively correlated with postoperative recurrence (HR = 0.09, 95% CI 0.01-0.87, p = .038). CONCLUSIONS Peripheral blood CD4+ T cell count can predict the CA recurrence rate after ALA-PDT in HIV-positive patients.
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Affiliation(s)
- Li Gu
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Shu Zhou
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Zhinan Shi
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Xiaoyu Zhai
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Liqun Gu
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Hua
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
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Durdu M, Ilkit M. Strategies to improve the diagnosis and clinical treatment of dermatophyte infections. Expert Rev Anti Infect Ther 2023; 21:29-40. [PMID: 36329574 DOI: 10.1080/14787210.2023.2144232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Significant problems are associated with the diagnosis and treatment of dermatophyte infections, which constitute the most common fungal infections of the skin. Although this is a common problem in the community, there are no adequate guidelines for the management of all forms of dermatophyte infections. Even if dermatophytes are correctly diagnosed, they sometimes exhibit poor susceptibility to several antifungal compounds. Therefore, long-term treatment may be needed, especially in immunosuppressed patients, for whom antifungal pharmacotherapy may be inconvenient owing to allergies and undesirable drug interaction-related effects. AREAS COVERED In this review article, problems related to the diagnosis and treatment of dermatophyte infections have been discussed, and suggestions to resolve these problems have been presented. EXPERT OPINION Pretreatment microscopic or mycological examinations should be performed for dermatophyte infections. In treatment-refractory cases, antifungal-resistant strains should be determined using antifungal susceptibility testing or via molecular methods. Natural herbal, laser, and photodynamic treatments can be used as alternative treatments in patients who cannot tolerate topical and systemic antifungal treatments.
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Affiliation(s)
- Murat Durdu
- Department of Dermatology, Faculty of Medicine, Başkent University Adana Hospital, Adana, Turkey
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey
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Wu X, Hu Y. Photodynamic Therapy for the Treatment of Fungal Infections. Infect Drug Resist 2022; 15:3251-3266. [PMID: 35761978 PMCID: PMC9233483 DOI: 10.2147/idr.s369605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Cutaneous fungal infections are common in humans and are associated with significant physical and psychological distress to patients. Although conventional topical and/or oral anti-fungal medications are commonly recommended treatments, drug resistance has emerged as a significant concern in this patient population, and safer, more efficacious, and cost-effective alternatives are warranted. Recent studies have reported effectiveness of photodynamic therapy (PDT) against fungal infections without severe adverse effects. In this review, we briefly discuss the mechanisms underlying PDT, current progress, adverse effects, and limitations of this treatment in the management of superficial and deep fungal infections.
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Affiliation(s)
- Xuelin Wu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Yongxuan Hu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
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Cai H, Che Y, Sun X, Yu X, Yu F, Hou F, Wang Y, Ma T. Clinical Outcome of Photodynamic Therapy for the Treatment of Cervical Intraepithelial Neoplasia Grade 2. Photodiagnosis Photodyn Ther 2022; 39:102906. [DOI: 10.1016/j.pdpdt.2022.102906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
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