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Liu B, Sood R, Wang F, Zhang F, Sun L, Qiu X, Zhao D, Lineaweaver WC. Principles and clinical applications of transcutaneous laser-assisted drug delivery: A narrative review. Scars Burn Heal 2024; 10:20595131241234715. [PMID: 38505821 PMCID: PMC10949547 DOI: 10.1177/20595131241234715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Introduction Transcutaneous laser-assisted drug delivery (LADD) is recognized as a developing therapy for skin disorders. Method Current literature was reviewed to summarize current applications for LADD. Discussion 12 clinical applications for this therapy are currently reported. Conclusion LADD has potential for wide application in skin disorder treatment. Lay Summary Laser assisted drug delivery improves drug bioavailability for treatment of skin disorders. This technique is being assessed clinically in disorders ranging from skin cancers to alopecia.
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Affiliation(s)
- Baoyi Liu
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Rajiv Sood
- Burn and Reconstruction Centers of America Augusta, Augusta, GA, USA
| | - Fuyang Wang
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Feng Zhang
- Burn and Reconstruction Centers of America Augusta, Augusta, GA, USA
| | - Lu Sun
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Xing Qiu
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Dewei Zhao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
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Wang T, Gao H, Wang D, Zhang C, Hu K, Zhang H, Lin J, Chen X. Stem cell-derived exosomes in the treatment of melasma and its percutaneous penetration. Lasers Surg Med 2023; 55:178-189. [PMID: 36573453 DOI: 10.1002/lsm.23628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/05/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Melasma is a refractory skin disease due to its complex pathogenesis and difficult treatment. Studies have found that human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos) could serve as a novel cell-free therapeutic strategy in regenerative and esthetic medicine. It could potentially treat melasma, but the skin barrier is a challenge. In this study, we aim to explore the safety and efficacy of hUCMSC-Exos in the treatment of melasma and the means to promote its percutaneous penetration. MATERIALS AND METHODS In the animal study about the effect of penetration, percutaneous penetration of PKH67-labeled hUCMSC-Exos was studied under microneedles, 1565 nm nonablative fractional laser (NAFL), and a plasma named Peninsula Blue Aurora Shumin Master (PBASM) treatments, observed by confocal laser scanning microscopy. In the clinical application study, 60 patients with melasma treated in our department were divided into four groups. NAFL combined with normal saline treatment was used for Group A. Microneedles, NAFL, and PBASM combined with hUCMSC-Exos treatments were used for Groups B, C, and D, respectively. Each patient received four treatments at 1-month intervals. Assessments were done using the degree of pain posttreatment, melasma area and severity score, improvement rate, physician global assessment score, satisfaction, and complications. RESULTS In the animal study about the effect of penetration, hUCMSC-Exos can penetrate the deep dermis under microneedles, NAFL, and PBASM treatments. In the clinical application study, compared with Group A, Groups B, C, and D showed significantly improved therapeutic effect and patient satisfaction (p < 0.05), and there was no significant difference among Groups B, C, and D.(p > 0.05). Patients in Group B reported higher pain levels than those in the other three groups (p < 0.05); the treatment experience of patients in Group D was better. CONCLUSION hUCMSC-Exos can improve the symptoms of melasma safely and effectively. Compared with microneedles, NAFL and PBASM can also achieve a good effect toward promoting penetration. These findings are worthy of exploration and clinical application.
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Affiliation(s)
- Ting Wang
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hangqi Gao
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Dezhi Wang
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chaoyu Zhang
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Kailun Hu
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Haoruo Zhang
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jian Lin
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaosong Chen
- Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, China
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Cao Y, Wang P, Liu X, Zhang G, Cao Z, Xue H, He Q, Wang X. Improving the outcome of treating striae gravidarum by combined therapies using topical β-glucan and 1565-nm non-ablative fractional laser: A prospective randomized vehicle-controlled parallel group study. J Dermatol 2022; 49:829-836. [PMID: 35570397 DOI: 10.1111/1346-8138.16417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 04/04/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
Striae gravidarum (SG) is a kind of dermal scar associated with psychosocial and therapeutic challenge. Topical reagents and non-invasive laser are more preferred than invasive procedures for less pain and shorter downtime. However, there are few studies on comparing and combining these two modalities. The aim of the present study was to evaluate the efficacy and tolerance of a topical regimen containing β-glucan, 1565-nm non-ablative fractional laser (NAFL; ResurFX), and combination of them for SG. A total of 128 unilateral abdomens from 64 subjects were randomly divided into four strategies and were followed up for 12 weeks: topical vehicle (Veh); topical β-glucan (B); 1565-nm NAFL combined topical vehicle (NAFL); 1565-nm NAFL combined topical β-glucan (B + NAFL). NAFL was applied three times with a 4-week interval. Topical reagent was applied b.i.d. for 12 weeks. Global Aesthetic Improvement Scale (GAIS) scores were assessed by blinded physician according to standard photograph, and by subjects at 12th week. The degree of SG atrophy was assessed by blinded physician before treatment and at the 12th week according to a standard 5-point scale. Collagen remodeling was evaluated by histological analysis and all adverse effects were recorded. A total of 56 women (112 unilateral abdomens) completed all study. The GAIS scores by blinded physician showed greater improvement in NAFL as compared with β-glucan, and by subjects showed greater improvement in β-glucan as compared with vehicle. In terms of striae atrophy scale, the improvement of SG atrophy was more prominent in NAFL compared to β-glucan, and in β-glucan + NAFL compared to Veh + NAFL. All treatments were well tolerated. Topical β-glucan regimen can mildly improve SG. NAFL showed better results than topical β-glucan regimen. The combined strategy may further improve the SG atrophy compared with single treatment strategy.
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Affiliation(s)
- Yajing Cao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaojing Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhi Cao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huan Xue
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiumin He
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Observation on the efficacy of 1565-nm non-ablative fractional laser combined with compound betamethasone topical application on the treatment of early scar in Chinese patients. Lasers Med Sci 2022; 37:2947-2953. [PMID: 35482129 DOI: 10.1007/s10103-022-03564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
The objective of the study was to evaluate the efficacy of combining 1565-nm non-ablative fractional laser with low-dose compound betamethasone topical application in the treatment of immature early red hypertrophic scar. We enrolled 38 cases of patients who had immature red hypertrophic scar due to surgery or trauma which are all less than 6 months old. About 28 patients were assigned to the treatment group, and 10 patients were assigned to the control group. The patients in the treatment group were all treated with 1565-nm non-ablative fractional laser with the following parameters: spot size 10-16 mm, round or square-shaped according to lesional morphology, fluence 20-35 mJ/cm2, and density 150-200 microspot/cm2. The treated area was then applied immediately with low-dose compound betamethasone through topical application. Treatment cycles were repeated every month for a total 5 months. Photos were taken before the start of the treatment, and then monthly after. Vancouver Scar Scale score was used to evaluate the scar changes; all the patients were followed up for 3 more months after the last treatment. All side effects were documented. The patients in the control group received no treatment at all. All the parameters were recorded as the same as the treatment group. The total VSS score after the combination therapy is 0.96 ± 1.53, which in comparison with prior treatment VSS score 8.86 ± 1.43, showed a significant reduction following the treatments (P < 0.001). The control group without any treatment shows VSS score 7.10 ± 0.99 at the end of the study vs VSS score 7.70 ± 0.82 at the start of the study (P > 0.05). The patient satisfaction rate reaches 89.2% after treatment, The major side effects reported include 3 patients with post-inflammatory hyperpigmentation (10.7% of patients in the treatment group), and other minor discomfort such as transient warmth, erythema, and swelling of treatment sites. The combination approach using 1565-nm non-ablative laser and low dose of local application of compound betamethasone can effectively improve the immature red hypertrophic scar with no significant side effects; this should provide our practitioners with a new weapon in fighting those hard-to-manage early scar formations.
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Lee WR, Hsiao CY, Chang ZY, Wang PW, Aljuffali IA, Lin JY, Fang JY. Cutaneous Delivery of Cosmeceutical Peptides Enhanced by Picosecond- and Nanosecond-Domain Nd:YAG Lasers with Quick Recovery of the Skin Barrier Function: Comparison with Microsecond-Domain Ablative Lasers. Pharmaceutics 2022; 14:pharmaceutics14020450. [PMID: 35214181 PMCID: PMC8880571 DOI: 10.3390/pharmaceutics14020450] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/07/2023] Open
Abstract
Picosecond or nanosecond-domain non-ablative lasers generate faster photothermal effects and cause less injury than microsecond lasers. In this study, we investigated the enhancing effect of 1064 nm picosecond- and nanosecond-domain neodymium (Nd):yttrium–aluminum–garnet (YAG) lasers on the cutaneous delivery of cosmeceutical peptides. Microsecond-domain fractional ablative CO2 and fully ablative erbium (Er):YAG lasers were also used for comparison. In the Franz diffusion cell study, pig or mouse skin was treated with a laser before exposure to palmitoyl tripeptide (PT)-1, PT-38, and copper tripeptide (CT)-1 at a concentration of 150 μM. Psoriasiform, atopic dermatitis (AD)-like, and photoaged skins were also developed as permeation barriers. The non-ablative laser elicited the ultrastructural disruption of the stratum corneum and epidermal vacuolation. All laser modalities significantly increased the skin permeation of peptides in vitro. The non-ablative laser chiefly enhanced peptide delivery to the receptor compartment, whereas the ablative laser mainly increased the intracutaneous peptide deposition. The picosecond- and nanosecond-domain Nd:YAG lasers elevated the amount of PT-1 in the receptor up to 40- and 22-fold compared with untreated skin, respectively. Laser treatment promoted peptide delivery in barrier-deficient and inflamed skins, although this enhancement effect was less than that observed in healthy skin. Fluorescence microscopy indicated the capability of the non-ablative laser to deliver peptides to deeper skin strata. The ablative laser confined the peptide distribution in the epidermis. Confocal microscopy showed that peptides penetrated the skin along the microdots created by the fractional Nd:YAG and CO2 lasers. The skin barrier function determined by transepidermal water loss suggested quick recovery when using a nanosecond-domain laser (within 4 h). A longer period was needed for the skin treated with the fully ablative Er:YAG laser (76–84 h). Nanosecond non-ablative laser-facilitated peptide delivery may become an efficient and safe approach for cosmeceutical applications.
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Affiliation(s)
- Woan-Ruoh Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 110, Taiwan;
- Department of Dermatology, Taipei Medical University Shuang Ho Hospital, New Taipei City 234, Taiwan
| | - Chien-Yu Hsiao
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Kweishan, Taoyuan 333, Taiwan;
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Kweishan, Taoyuan 333, Taiwan
- Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Kweishan, Taoyuan 333, Taiwan
| | - Zi-Yu Chang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Pei-Wen Wang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan;
| | - Ibrahim A. Aljuffali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Jie-Yu Lin
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Kweishan, Taoyuan 333, Taiwan;
| | - Jia-You Fang
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Kweishan, Taoyuan 333, Taiwan
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Kweishan, Taoyuan 333, Taiwan;
- Department of Anesthesiology, Chang Gung Memorial Hospital, Kweishan, Taoyuan 333, Taiwan
- Correspondence:
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Wang JV, Mehrabi JN, Zachary CB, Geronemus RG. Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery. Dermatol Surg 2022; 48:120-125. [PMID: 34904578 DOI: 10.1097/dss.0000000000003275] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Topical medications play a large role in the management of cutaneous diseases, but penetration is limited. Device-assisted drug delivery using mechanical destruction, lasers, and other energy-based modalities can increase penetration and absorption through creation of transcutaneous channels. OBJECTIVE To examine real-time, in vivo cutaneous changes in response to various devices used to improve topical drug delivery through optical coherence tomography (OCT) imaging. METHODS AND MATERIALS Treatment was performed with 8 medical devices, including mechanical destruction, lasers, and other energy-based modalities. Optical coherence tomography was used for real-time, noninvasive, in vivo imaging. RESULTS Using OCT, microneedling and radiofrequency microneedling demonstrated no cutaneous channels. Both low-energy, low-density, fractional nonablative lasers produced transient channels, which closed within hours. The fractional nonablative 1,927-nm thulium fiber and 1,550-nm erbium fiber lasers created channels with epidermal debris within, which were still closing at 24 hours. The fractional thermomechanical ablative device and the fractional ablative CO2 laser produced channels that were still open at 24 hours. CO2 laser channels had thick rims of coagulated tissue and remained open for longer. CONCLUSION Demonstrable differences among the devices were seen, and only some can produce observable channels, the characteristics of which vary with each technology.
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Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | - Joseph N Mehrabi
- Department of Dermatology, University of California, Irvine, California
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Hsiao CY, Yang SC, Alalaiwe A, Fang JY. Laser ablation and topical drug delivery: a review of recent advances. Expert Opin Drug Deliv 2019; 16:937-952. [DOI: 10.1080/17425247.2019.1649655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Chien-Yu Hsiao
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Chun Yang
- Department of Cosmetic Science, Providence University, Taichung, Taiwan
| | - Ahmed Alalaiwe
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Jia-You Fang
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Taoyuan, Taiwan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Suchonwanit P, Rojhirunsakool S, Khunkhet S. A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia. Lasers Med Sci 2019; 34:1857-1864. [DOI: 10.1007/s10103-019-02783-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 04/02/2019] [Indexed: 11/30/2022]
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Wong TH, Morton CA, Collier N, Haylett A, Ibbotson S, McKenna KE, Mallipeddi R, Moseley H, Seukeran DC, Rhodes LE, Ward KA, Mohd Mustapa MF, Exton LS. British Association of Dermatologists and British Photodermatology Group guidelines for topical photodynamic therapy 2018. Br J Dermatol 2018; 180:730-739. [PMID: 30506819 DOI: 10.1111/bjd.17309] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
Affiliation(s)
- T H Wong
- Stirling Community Hospital, Stirling, FK8 2AU, U.K
| | - C A Morton
- Stirling Community Hospital, Stirling, FK8 2AU, U.K
| | - N Collier
- Photobiology Unit, Dermatology Centre, University of Manchester and Salford Royal NHS Foundation Trust, Manchester, M6 8HD, U.K
| | - A Haylett
- Photobiology Unit, Dermatology Centre, University of Manchester and Salford Royal NHS Foundation Trust, Manchester, M6 8HD, U.K
| | - S Ibbotson
- Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, U.K
| | - K E McKenna
- Department of Dermatology, Belfast City Hospital, Belfast, BT9 7AB, U.K
| | - R Mallipeddi
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K
| | - H Moseley
- Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, U.K
| | - D C Seukeran
- The James Cook University Hospital, Middleborough, TS4 3BW, U.K
| | - L E Rhodes
- Photobiology Unit, Dermatology Centre, University of Manchester and Salford Royal NHS Foundation Trust, Manchester, M6 8HD, U.K
| | - K A Ward
- Cannock Chase Hospital, Cannock, WS11 5XY, U.K
| | - M F Mohd Mustapa
- British Association of Dermatologists, Willan House, 4 Fitzroy Square, London, W1T 5HQ, U.K
| | - L S Exton
- British Association of Dermatologists, Willan House, 4 Fitzroy Square, London, W1T 5HQ, U.K
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Shin EJ, Seo JK, Lee EJ, Lee ES, Shin MK. Diagnostic utility of skin autofluorescence when patch test results are doubtful. Skin Res Technol 2018; 25:96-99. [PMID: 30055047 DOI: 10.1111/srt.12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The standard diagnostic test for allergic contact dermatitis is the patch test, which can also be used to identify irritant contact dermatitis. Doubtful reactions (?+) can be often clinically relevant to individuals and can require additional tests. OBJECTIVES The purpose of this study was to examine whether autofluorescence (AF) measurements in patients with doubtful reactions are helpful in diagnosing contact dermatitis. METHODS Patients with a history of contact dermatitis were patch tested on the upper back for 48-hours of occlusion using aqueous solutions of 5% sodium lauryl sulfate. Reaction intensity was scored, and AF was measured on reactive lesions and non-lesions. Three dermatologists classified the results as positive or negative using the fluorescence photographs of patients with a doubtful reaction. RESULTS Among doubtful reactions, the R/G% values were significantly higher in the AF- based positive group than in the negative group (P = .0086). On the other hand, the heterogeneity values of R, G, and B (HR, HG, HB) were significantly lower in the AF-based positive group (P = .0026, .0046, .0004 respectively). CONCLUSIONS Measuring AF along with the clinical readings can help confirm doubtful patch test reactions.
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Affiliation(s)
- E-J Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - J-K Seo
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - E J Lee
- Skin Research Center/DERMAPRO Ltd., Seoul, Korea
| | - E S Lee
- Skin Research Center/DERMAPRO Ltd., Seoul, Korea
| | - M K Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
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Lee WR, Shen SC, Sung CT, Liu PY, Fang JY. Is the Fractional Laser Still Effective in Assisting Cutaneous Macromolecule Delivery in Barrier-Deficient Skin? Psoriasis and Atopic Dermatitis as the Disease Models. Pharm Res 2018; 35:128. [PMID: 29700662 DOI: 10.1007/s11095-018-2413-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/18/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Most of the investigations into laser-assisted skin permeation have used the intact skin as the permeation barrier. Whether the laser is effective in improving cutaneous delivery via barrier-defective skin is still unclear. METHODS In this study, ablative (Er:YAG) and non-ablative (Er:glass) lasers were examined for the penetration of peptide and siRNA upon topical application on in vitro skin with a healthy or disrupted barrier. RESULTS An enhanced peptide flux (6.9 fold) was detected after tape stripping of the pig stratum corneum (SC). A further increase of flux to 11.7 fold was obtained after Er:YAG laser irradiation of the SC-stripped skin. However, the application of Er:glass modality did not further raise the flux via the SC-stripped skin. A similar trend was observed in the case of psoriasiform skin. Conversely, the flux was enhanced 3.7 and 2.6 fold after treatment with the Er:YAG and the Er:glass laser on the atopic dermatitis (AD)-like skin. The 3-D skin structure captured by confocal microscopy proved the distribution of peptide and siRNA through the microchannels and into the surrounding tissue. CONCLUSIONS The fractional laser was valid for ameliorating macromolecule permeation into barrier-disrupted skin although the enhancement level was lower than that of normal skin.
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Affiliation(s)
- Woan-Ruoh Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Shing-Chuan Shen
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan
| | - Calvin T Sung
- School of Medicine, University of California, Riverside, California, USA
| | - Pei-Ying Liu
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, 259 Wen-Hwa 1st Road, Kweishan, Taoyuan, 333, Taiwan
| | - Jia-You Fang
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, 259 Wen-Hwa 1st Road, Kweishan, Taoyuan, 333, Taiwan. .,Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1st Road, Kweishan, Taoyuan, 333, Taiwan. .,Research Center for Industry of Human Ecology and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan. .,Department of Anesthesiology, Chang Gung Memorial Hospital, Kweishan, Taoyuan, Taiwan.
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Braun SA, Schrumpf H, Buhren BA, Homey B, Gerber PA. Laser-assisted drug delivery: mode of action and use in daily clinical practice. J Dtsch Dermatol Ges 2018; 14:480-8. [PMID: 27119468 DOI: 10.1111/ddg.12963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Topical application of pharmaceutical agents is a basic principle of dermatological therapy. However, the effective barrier function of the skin significantly impairs the bioavailability of most topical drugs. Fractional ablative lasers represent an innovative strategy to overcome the epidermal barrier in a standardized, contact-free manner. The bioavailability of topical agents can be significantly enhanced using laser-assisted drug delivery (LADD). In recent years, the principle of LADD has become well established for various dermatological indications. Herein, we review the current literature on LADD and present potential future applications.
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Affiliation(s)
| | - Holger Schrumpf
- Department of Dermatology, Heinrich Heine University, Düsseldorf, Germany
| | | | - Bernhard Homey
- Department of Dermatology, Heinrich Heine University, Düsseldorf, Germany
| | - Peter Arne Gerber
- Department of Dermatology, Heinrich Heine University, Düsseldorf, Germany
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14
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Transepidermal Drug Delivery and Photodynamic Therapy. LASERS, LIGHTS AND OTHER TECHNOLOGIES 2018. [DOI: 10.1007/978-3-319-16799-2_36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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15
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Choi JH, Shin EJ, Jeong KH, Shin MK. Comparative analysis of the effects of CO2 fractional laser and sonophoresis on human skin penetration with 5-aminolevulinic acid. Lasers Med Sci 2017; 32:1895-1900. [DOI: 10.1007/s10103-017-2305-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 08/06/2017] [Indexed: 11/30/2022]
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Kim TI, Ahn HJ, Kang IH, Jeong KH, Kim NI, Shin MK. Nonablative fractional laser-assisted daylight photodynamic therapy with topical methyl aminolevulinate for moderate to severe facial acne vulgaris: Results of a randomized and comparative study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:253-259. [DOI: 10.1111/phpp.12312] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 01/17/2023]
Affiliation(s)
- Tae In Kim
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Hye-Jin Ahn
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - In Hye Kang
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Ki-Heon Jeong
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Nack In Kim
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Min Kyung Shin
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
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17
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Shin EJ, Gwak MJ, Jeong KH, Shin MK. Lack of differentiation of allergic and irritant reactions by skin autofluorescence. Contact Dermatitis 2017; 76:318-321. [PMID: 28386970 DOI: 10.1111/cod.12708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Eun Jae Shin
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, 02447, Korea
| | - Min Jae Gwak
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, 02447, Korea
| | - Ki Heon Jeong
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, 02447, Korea
| | - Min Kyung Shin
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, 02447, Korea
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18
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Non-Ablative Fractional Laser to Facilitate Transdermal Delivery. J Pharm Sci 2016; 105:3324-3332. [DOI: 10.1016/j.xphs.2016.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/03/2016] [Accepted: 07/26/2016] [Indexed: 12/11/2022]
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19
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Qureshi S, Lin JY. Utilizing non-ablative fractional photothermolysis prior to ALA-photodynamic therapy in the treatment of acne vulgaris: a case series. Lasers Med Sci 2016; 32:729-732. [DOI: 10.1007/s10103-016-2029-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 07/12/2016] [Indexed: 10/20/2022]
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20
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Non-ablative fractional laser assists cutaneous delivery of small- and macro-molecules with minimal bacterial infection risk. Eur J Pharm Sci 2016; 92:1-10. [DOI: 10.1016/j.ejps.2016.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/20/2016] [Accepted: 06/20/2016] [Indexed: 12/26/2022]
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22
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Thunshelle C, Yin R, Chen Q, Hamblin MR. Current Advances in 5-Aminolevulinic Acid Mediated Photodynamic Therapy. CURRENT DERMATOLOGY REPORTS 2016; 5:179-190. [PMID: 28163981 DOI: 10.1007/s13671-016-0154-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Kennedy and Pottier discovered that photodynamic therapy (PDT) could be carried out using a procedure consisting of topical application of the porphyrin-precursor, 5-aminolevulinic acid (ALA) to the skin, followed after some time by illumination with various light parameters in the 1980s. Since then, ALA-PDT has expanded enormously and now covers most aspects of dermatological disease. The purpose of this review is to discuss a range of ingenious strategies that investigators have devised for improving the overall outcome (higher efficiency and lower side effects) of ALA-PDT. The big advance of using ALA esters instead of the free acid to improve skin penetration was conceived in the 1990s. A variety of more recent innovative approaches can be divided into three broad groups: (a) those relying on improving delivery or penetration of ALA into the skin; (b) those relying on ways to increase the synthesis of protoporphyrin IX inside the skin; (c) those relying on modification of the illumination parameters. In the first group, we have improved delivery of ALA with penetration-enhancing chemicals, iontophoresis, intracutaneous injection, or fractionated laser. There is also a large group of nanotechnology-related approaches with ALA being delivered using liposomes/ethosomes, ALA dendrimers, niosomes, mesoporous silica nanoparticles, conjugated gold nanoparticles, polymer nanoparticles, fullerene nanoparticles, and carbon nanotubes. In the second group, we can find the use of cellular differentiating agents, the use of iron chelators, and the effect of increasing the temperature. In the third group, we find methods designed to reduce pain as well as improve efficiency including fractionated light, daylight PDT, and wearable light sources for ambulatory PDT. This active area of research is expected to continue to provide a range of intriguing possibilities.
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Affiliation(s)
- Connor Thunshelle
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA; Harvard College, Cambridge, MA 02138, USA
| | - Rui Yin
- Southwest Hospital, Third Military Medical University, Chongqing 40038, China
| | - Qiquan Chen
- Southwest Hospital, Third Military Medical University, Chongqing 40038, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA
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23
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Choi JW, Kim TI, Jeong KH, Shin MK. A case of successfully treated recalcitrant EGFR inhibitor-induced acneiform eruption following non-ablative fractional laser. Dermatol Ther 2016; 29:252-4. [PMID: 27146102 DOI: 10.1111/dth.12361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Epidermal growth factor receptor (EGFR) inhibitor, a targeted therapy in the field of oncology, is a new drugs suggested for the cause of acneiform eruptions. The unresponsiveness to conventional acne therapy is a pivotal reason of seeking alternatives to treat drug-induced acneiform eruptions. A 30-year-old female treated with cetuximab, EGFR inhibitor presented with numerous sized erythematous papules and pustules on her face. All responses of oral medications and topical application were poor. She was treated with two passes of non-ablative 1550 nm fractional erbium glass laser with topical clindamycin. After three laser sessions, the skin lesions improved dramatically without any side effects. There is currently no single effective treatment for acneiform eruption. This report shed light on the possibility that non-ablative fractional laser can be an alternative for recalcitrant drug-induced acneiform eruptions.
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Affiliation(s)
- Joong Woon Choi
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Tae In Kim
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ki-Heon Jeong
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Min Kyung Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
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Braun SA, Schrumpf H, Buhren BA, Homey B, Gerber PA. Laser assisted Drug Delivery: Grundlagen und Praxis. J Dtsch Dermatol Ges 2016; 14:480-9. [DOI: 10.1111/ddg.12963_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Chitvanich S, Rerknimitr P, Panchaprateep R, Pongprutthipan M, Asawanonda P. Combination of non-ablative fractional photothermolysis and 0.1% tacrolimus ointment is efficacious for treating idiopathic guttate hypomelanosis. J DERMATOL TREAT 2016; 27:456-60. [DOI: 10.3109/09546634.2015.1133883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Laser-assisted drug delivery in dermatology: from animal models to clinical practice. Lasers Med Sci 2015; 31:373-81. [DOI: 10.1007/s10103-015-1853-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 12/08/2015] [Indexed: 11/25/2022]
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27
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Choi S, Kim K, Song K. Efficacy of ablative fractional laser-assisted photodynamic therapy with short-incubation time for the treatment of facial and scalp actinic keratosis: 12-month follow-up results of a randomized, prospective, comparative trial. J Eur Acad Dermatol Venereol 2015; 29:1598-605. [DOI: 10.1111/jdv.12953] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/05/2014] [Indexed: 01/03/2023]
Affiliation(s)
- S.H. Choi
- Department of Dermatology; College of Medicine; Dong-A University; Busan South Korea
| | - K.H. Kim
- Department of Dermatology; College of Medicine; Dong-A University; Busan South Korea
| | - K.H. Song
- Department of Dermatology; College of Medicine; Dong-A University; Busan South Korea
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28
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Affiliation(s)
- B.S. Bloom
- The Ronald O. Perelman Department of Dermatology; New York University School of Medicine; New York NY U.S.A
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