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Wu C, Qiu X, He C, Ci C. Effect of 5-Aminolevulinic Acid Photodynamic Therapy with Transfer Factor Capsules in the Treatment of Multiple Plantar Warts. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1220889. [PMID: 36425335 PMCID: PMC9681558 DOI: 10.1155/2022/1220889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 10/29/2023]
Abstract
BACKGROUND Plantar warts are a common cutaneous disease of the sole of the foot caused by human papillomavirus. Photodynamic therapy has gained increasing attention in the treatment of plantar warts. OBJECTIVE To investigate the effect of photodynamic therapy combined with transfer factor capsules in the treatment of multiple plantar warts. METHODS Sixty-one patients with multiple plantar warts who visited our outpatient department from September 2017 to August 2019 were randomly divided into two groups. Twenty-three patients received photodynamic therapy (treatment group) and thirty-eight received cryotherapy (control group). Both groups also received immune modulator transfer factor capsules. Skin lesion score, numeric rating scale- (NRS-) 10 score, recurrence rate, adverse reactions, and Dermatology Life Quality Index (DLQI) were analyzed in both groups. RESULTS The mean skin lesion score improved from 13.39 ± 3.88 before treatment to 1.48 ± 2.50 after the last treatment in the treatment group and from 12.47 ± 2.99 before treatment to 4.47 ± 3.67 after the last treatment in the control group. The success rate after 3 months of treatment was 86.96% in the treatment group and 39.47% in the control group. After 3 months of follow-up, the recurrence rate was significantly lower in the treatment group (20%) than in the control group (53.33%). The mean DLQI score at three months after treatment was significantly lower in the treatment group (3.61 ± 1.16) than in the control group (6.31 ± 2.59). CONCLUSION Photodynamic therapy combined with immunomodulators significantly increased the cure rate and reduced the recurrence rate of multiple plantar warts compared with traditional cryotherapy combined with immunomodulators.
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Affiliation(s)
- Chen Wu
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Xiamin Qiu
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Caifeng He
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Chao Ci
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
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Sharma A, Vincent L. Actinic keratosis area and severity index is not correlated with photodynamic therapy procedural pain. Photodiagnosis Photodyn Ther 2020; 31:101946. [PMID: 32795507 DOI: 10.1016/j.pdpdt.2020.101946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/20/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Actinic Keratosis Area and Severity Index (AKASI) is a validated quantitative tool used to measure the severity of actinic keratoses. Given the success of AKASI in measuring outcomes and therapies related to actinic damage, we hypothesized that AKASI would be correlated to photodynamic therapy (PDT)-related pain. The aim of this study was to evaluate AKASI's correlation with PDT-associated pain for patients with AKs being treated with 5-Aminolevulinic acid (ALA) PDT. METHODS Thirty consecutive patients being treated for AKs with ALA PDT on the face and/or scalp were recruited from a single center. The AKASI of the treated areas were collected. The patient underwent a standard treatment with ALA-PDT for a total of 10 J/cm2 to treated area. Immediate post-procedural pain scores were measured using a visual-analog pain scale. Pain and AKASI scores were analyzed using Pearson's correlation coefficient. RESULTS AKASI was not correlated to pain score (Pearson correlation coefficient was 0.027, p = 0.87). In sub-group analyses, there was no strong correlation between the scalp AKASI or face AKASI and respective pain scores (p = 0.59 and p = 0.38, respectively). Furthermore, there was no strong correlation between the individual components of AKASI and pain score: distribution (p = 0.26), erythema (p = 0.66) and thickness (p = 0.43). CONCLUSION There is no correlation between the AKASI score and perceived pain from PDT. Therefore, the need for pain relief using a fan and evaporative cooling should be anticipated for all patients. We feel that this negative result is noteworthy as it supports mechanisms outside of AK destruction as the cause of immediate PDT-related pain.
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Gubarkova EV, Feldchtein FI, Zagaynova EV, Gamayunov SV, Sirotkina MA, Sedova ES, Kuznetsov SS, Moiseev AA, Matveev LA, Zaitsev VY, Karashtin DA, Gelikonov GV, Pires L, Vitkin A, Gladkova ND. Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study. Sci Rep 2019; 9:18670. [PMID: 31822752 PMCID: PMC6904495 DOI: 10.1038/s41598-019-55215-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/26/2019] [Indexed: 01/10/2023] Open
Abstract
Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.
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Affiliation(s)
- E V Gubarkova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia.
| | - F I Feldchtein
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - E V Zagaynova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - S V Gamayunov
- A. Tsyb Medical Radiological Research Center, Korolev Street 4, Obninsk, 249036, Kaluga region, Russia
| | - M A Sirotkina
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - E S Sedova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - S S Kuznetsov
- N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Rodionova Street 190, 603093, Nizhny Novgorod, Russia
| | - A A Moiseev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - L A Matveev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - V Y Zaitsev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - D A Karashtin
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - G V Gelikonov
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - L Pires
- University of Toronto and University Health Network, 610 University Ave., Toronto, Ontario, M5G 2M9, Canada
| | - A Vitkin
- University of Toronto and University Health Network, 610 University Ave., Toronto, Ontario, M5G 2M9, Canada
| | - N D Gladkova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
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Johansen MB, Jemec GB, Fabricius S. Effective treatment with photodynamic therapy of cutaneous leishmaniasis: A case report. Dermatol Ther 2019; 32:e13022. [DOI: 10.1111/dth.13022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/04/2019] [Accepted: 07/11/2019] [Indexed: 12/22/2022]
Affiliation(s)
| | - Gregor B.E. Jemec
- Department of DermatologyZealand University Hospital Roskilde Denmark
| | - Susanne Fabricius
- Department of DermatologyZealand University Hospital Roskilde Denmark
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5
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Nguyen K, Khachemoune A. An update on topical photodynamic therapy for clinical dermatologists. J DERMATOL TREAT 2019; 30:732-744. [DOI: 10.1080/09546634.2019.1569752] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Khoa Nguyen
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, Brooklyn, NY, USA
- Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
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6
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Lydon E, Dawe R, Ibbotson S. Factors influencing pain and efficacy of topical photodynamic therapy: a retrospective study. Br J Dermatol 2018; 180:205-206. [DOI: 10.1111/bjd.17204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E. Lydon
- Photobiology Unit, Dermatology Department University of Dundee, Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - R.S. Dawe
- Photobiology Unit, Dermatology Department University of Dundee, Ninewells Hospital and Medical School Dundee DD1 9SY U.K
| | - S.H. Ibbotson
- Photobiology Unit, Dermatology Department University of Dundee, Ninewells Hospital and Medical School Dundee DD1 9SY U.K
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Ibbotson S, Wong T, Morton C, Collier N, Haylett A, McKenna K, Mallipeddi R, Moseley H, Rhodes L, Seukeran D, Ward K, Mohd Mustapa M, Exton L. Adverse effects of topical photodynamic therapy: a consensus review and approach to management. Br J Dermatol 2018; 180:715-729. [DOI: 10.1111/bjd.17131] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2018] [Indexed: 12/21/2022]
Affiliation(s)
- S.H. Ibbotson
- Photobiology Unit Department of Dermatology University of Dundee Ninewells Hospital and Medical School Dundee U.K
| | - T.H. Wong
- Stirling Community Hospital StirlingU.K
| | | | - N.J. Collier
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | - A. Haylett
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | - K.E. McKenna
- Department of Dermatology Belfast City Hospital BelfastU.K
| | - R. Mallipeddi
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - H. Moseley
- Photobiology Unit Department of Dermatology University of Dundee Ninewells Hospital and Medical School Dundee U.K
| | - L.E. Rhodes
- Photobiology Unit Dermatology Centre University of Manchester and Salford Royal NHS Foundation Trust ManchesterU.K
| | | | | | | | - L.S. Exton
- British Association of Dermatologists London U.K
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8
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Marra K, LaRochelle EP, Chapman MS, Hoopes PJ, Lukovits K, Maytin EV, Hasan T, Pogue BW. Comparison of Blue and White Lamp Light with Sunlight for Daylight-Mediated, 5-ALA Photodynamic Therapy, in vivo. Photochem Photobiol 2018; 94:1049-1057. [PMID: 29663426 DOI: 10.1111/php.12923] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/02/2018] [Indexed: 12/24/2022]
Abstract
Daylight-mediated photodynamic therapy (d-PDT) as a treatment for actinic keratosis (AK) is an increasingly common technique due to a significant reduction in pain, leading to better patient tolerability. While past studies have looked at different light sources and delivery methods, this study strives to provide equivalent PpIX-weighted light doses with the hypothesis that artificial light sources could be equally as effective as natural sunlight if their PpIX-weighted fluences were equalized. Normal mouse skin was used as the model to compare blue LED light, metal halide white light and natural sunlight, with minimal incubation time between topical ALA application and the onset of light delivery. A total PpIX-weighted fluence of 20 Jeff cm-2 was delivered over 2 h, and the efficacy of response was quantified using three acute bioassays for PDT damage: PpIX photobleaching, Stat3 crosslinking and quantitative histopathology. These bioassays indicated blue light was slightly inferior to both sunlight and white light, but that the latter two were not significantly different. The results suggest that metal halide white light could be a reasonable alternative to daylight PDT, which should allow a more controlled treatment that is independent of weather and yet should have similar response rates with limited pain during treatment.
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Affiliation(s)
- Kayla Marra
- Thayer School of Engineering, Dartmouth College, Hanover, NH
| | | | - M Shane Chapman
- Department of Surgery, Geisel School of Medicine, Hanover, NH
| | - P Jack Hoopes
- Department of Surgery, Geisel School of Medicine, Hanover, NH
| | - Karina Lukovits
- Thayer School of Engineering, Dartmouth College, Hanover, NH
| | - Edward V Maytin
- Department of Biomedical Engineering, Learner Research Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH.,Department of Surgery, Geisel School of Medicine, Hanover, NH
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Yazdanyar S, Zarchi K, Jemec GBE. Pain during topical photodynamic therapy - comparing methyl aminolevulinate (Metvix ®) to aminolaevulinic acid (Ameluz ®); an intra-individual clinical study. Photodiagnosis Photodyn Ther 2017; 20:6-9. [PMID: 28780136 DOI: 10.1016/j.pdpdt.2017.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/14/2017] [Accepted: 07/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Actinic keratoses are often treated by photodynamic therapy. However, the main side effect of this treatment is pain during and shortly after illumination. OBJECTIVES To evaluate, in an intra-individual study, whether the pain response differ in treatment of actinic keratoses in scalp and forhead, using branded methyl aminolevulinate (MAL) and aminolaevulinic acid (ALA). MATERIALS AND METHODS Patients with mild to moderate actinic keratoses on forehead and scalp were treated with methyl aminolaevulinate (MAL)-PDT and aminolaevulinic acid (ALA)-PDT on two similar areas of forehead and scalp. The pain response were measured using visual analogue scale ranging from 0 to 10 during the illumination and 30min after the treatment. RESULTS Fourteen patients completed treatment to MAL and ALA-PDT. We found no significant difference in pain intensity between MAL and ALA-PDT, neither during the treatment (p-value=1) nor 30min after the treatment (p-value of 0.19). CONCLUSIONS This intra-individual study demonstrate no significant difference between the pain response during PDT using methyl aminolevulinate and aminolaevulinic acid.
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Affiliation(s)
- Shiva Yazdanyar
- Department of Dermatology, Roskilde Hospital; Health Sciences Faculty, University of Copenhagen, Denmark.
| | - Kian Zarchi
- Department of Dermatology, Roskilde Hospital; Health Sciences Faculty, University of Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Roskilde Hospital; Health Sciences Faculty, University of Copenhagen, Denmark
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10
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Wang B, Shi L, Zhang Y, Zhou Q, Zheng J, Szeimies R, Wang X. Gain with no pain? Pain management in dermatological photodynamic therapy. Br J Dermatol 2017; 177:656-665. [PMID: 28122416 DOI: 10.1111/bjd.15344] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/30/2022]
Affiliation(s)
- B. Wang
- Department of Dermatology Ruijin Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - L. Shi
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - Y.F. Zhang
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - Q. Zhou
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
| | - J. Zheng
- Department of Dermatology Ruijin Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - R.M. Szeimies
- Department of Dermatology and Allergology Vest Clinic Recklinghausen Germany
| | - X.L. Wang
- Institute of Photomedicine Shanghai Skin Disease Hospital Tongji University School of Medicine 1278 Baode Road Shanghai 200443 China
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11
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Hambly RA, Mansoor N, Quinlan C, Shah Z, Lenane P, Ralph N, Moloney FJ. Factors predicting pain and effect of oral analgesia in topical photodynamic therapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:176-179. [PMID: 28196277 DOI: 10.1111/phpp.12301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Roisin A Hambly
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Nazish Mansoor
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Catherine Quinlan
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Zahra Shah
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Patsy Lenane
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Nicola Ralph
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Fergal J Moloney
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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12
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Torsnes L, Heidenheim M, Jemec G. Comment on ‘Transient memory impairment and transient global amnesia induced by photodynamic therapy’. Br J Dermatol 2016; 174:237. [DOI: 10.1111/bjd.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L.R. Torsnes
- Department of Dermatology Roskilde Hospital Roskilde Denmark
- Dermatologisk afd Roskilde Sygehus Køgevej 7–13 4000 Roskilde Denmark
| | - M. Heidenheim
- Department of Dermatology Roskilde Hospital Roskilde Denmark
| | - G.B.E. Jemec
- Department of Dermatology Roskilde Hospital Roskilde Denmark
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13
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Themstrup L, Banzhaf C, Mogensen M, Jemec G. Optical coherence tomography imaging of non-melanoma skin cancer undergoing photodynamic therapy reveals subclinical residual lesions. Photodiagnosis Photodyn Ther 2014; 11:7-12. [DOI: 10.1016/j.pdpdt.2013.11.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/12/2013] [Accepted: 11/13/2013] [Indexed: 11/16/2022]
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14
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Fabricius S, Lerche CM, Philipsen PA, Wulf HC. The relation between methyl aminolevulinate concentration and inflammation after photodynamic therapy in healthy volunteers. Photochem Photobiol Sci 2013; 12:117-23. [PMID: 22785615 DOI: 10.1039/c2pp25128k] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Inflammation and pain are well known adverse-effects in photodynamic therapy (PDT). There is currently a tendency towards introducing lower concentrations of the photosensitizer than used in the standard treatment for various indications. The aim of this study was to investigate whether reduced concentrations of methyl aminolevulinate (MAL) can reduce inflammation (erythema) during PDT treatment. We measured the formation of protoporphyrin IX (PpIX) using fluorescence and monitored both erythema and pain during and after PDT treatment with conventional 16% MAL and threee reduced concentrations of 2, 0.75, and 0.25% in twenty-four healthy volunteers. We found that lowering the MAL concentration reduced PpIX fluorescence and erythema after PDT treatment. There was a strong correlation (R(2) = 0.70) between the PpIX fluorescence and erythema after treatment. A further increase in erythema after PDT was dependent on pre-treatment skin erythema. PpIX fluorescence could explain 70% of the increase in erythema (P < 0.0005). Pain and post-treatment hyperpigmentation can be reduced but not eliminated by limiting the MAL concentration. An efficacy study of PDT with these three reduced concentrations has not been performed.
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Wiegell S, Fabricius S, Gniadecka M, Stender I, Berne B, Kroon S, Andersen B, Mørk C, Sandberg C, Ibler K, Jemec G, Brocks K, Philipsen P, Heydenreich J, Haedersdal M, Wulf H. Daylight-mediated photodynamic therapy of moderate to thick actinic keratoses of the face and scalp: a randomized multicentre study. Br J Dermatol 2012; 166:1327-32. [DOI: 10.1111/j.1365-2133.2012.10833.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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