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Jaalouk D, Pulumati A, Algarin YA, Humeda J, Goldberg DJ. The impact of energy-based devices on sebum in acne vulgaris: A systematic review. J Cosmet Dermatol 2024; 23:3066-3077. [PMID: 39129257 DOI: 10.1111/jocd.16466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Acne vulgaris (AV) is a widespread inflammatory skin condition associated with increased sebum production, abnormal keratinization, bacterial overgrowth, and inflammation. Overactive sebaceous glands (SGs) produce excess sebum, promote Cutibacterium acnes growth, and affect acne development. Energy-based treatments (EBDs), including light therapy, photodynamic therapy (PDT), lasers, and radiofrequency (RF) devices, have emerged as effective treatment options. As the use of EBDs becomes more widespread, it is imperative to understand their effects on skin parameters, such as sebum, in AV. METHODS Searches were conducted in Embase, PubMed, Web of Science, and the Cochrane Library. The studies included were randomized and nonrandomized trials on facial AV that used EBDs and featured objective casual sebum level (CSL) measurements via Sebumeter. Data synthesis involved percentage reductions in CSL at follow-ups compared to baseline. RESULTS Twenty-three studies were analyzed. PDT and RF consistently reduced CSL by 30%-40% and 30%-35%, respectively. Laser therapy showed lesser reductions, whereas light therapy varied significantly and studies had a high risk of bias. All EBD therapies were more effective than no treatment and PDT was superior to light monotherapy. Laser therapy combined with fractional microneedling radiofrequency (FMR) or as a standalone was more effective than laser alone. CONCLUSION Noninvasive sebum measurement provides valuable insights into AV treatment efficacy. PDT, lasers, especially the 1450-nm diode laser, and FMR are promising for reducing sebum. Standardization of measurement techniques and further research are vital for enhancing treatment personalization, reducing side effects, and improving AV management.
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Affiliation(s)
- Dana Jaalouk
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - Anika Pulumati
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Yanci A Algarin
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jasmine Humeda
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - David J Goldberg
- Skin Laser & Surgery Specialists, A Division of Schweiger Dermatology Group, New York, New York, USA
- Icahn School of Medicine, Mount Sinai, New York, New York, USA
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2
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Buniowska I, Wronski N, Insinska-Rak M, Sikorski M, Wolnicka-Glubisz A. Tetraacetyl riboflavin derivative mediates caspase 3/7 activation via MAPK in A431 cells upon blue light influence. Photochem Photobiol 2024; 100:204-213. [PMID: 37029736 DOI: 10.1111/php.13806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
An acetylated riboflavin derivative, 3-methyl-tetraacetyl riboflavin (3MeTARF), is a compound with high photostability and photophysical properties similar to riboflavin, including the ability to photogenerate singlet oxygen. In the present study, we compared the effects of irradiation on A431 cancer cells with blue LED light (438 nm) in the presence of 3MeTARF and riboflavin on MAPK phosphorylation, apoptosis, caspase 3/7 activation and PARP cleavage. We observed that photogenerated oxidative stress in this reaction activates MAPK by increasing phosphorylation of p38 and JNK proteins. Preincubation of cells with inhibitors specific for phosphorylation of p38 and JNK proteins (SB203580, SP600125), respectively, results in decreased caspase 3/7 activation and PARP cleavage. We showed that the tetraacetyl derivative more effectively activates MAPK and skin cancer cell death compared to riboflavin. These data, together with results of our previous study, support the hypothesis that 3MeTARF, of riboflavin, might be more useful and desirable as a compound for use in photodynamic oxidation processes, including its therapeutic potential.
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Affiliation(s)
- Izabela Buniowska
- Department of Biophysics and Cancer Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Norbert Wronski
- Department of Biophysics and Cancer Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | | | - Marek Sikorski
- Faculty of Chemistry, Adam Mickiewicz University, Poznań, Poland
| | - Agnieszka Wolnicka-Glubisz
- Department of Biophysics and Cancer Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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Insińska-Rak M, Sikorski M, Wolnicka-Glubisz A. Riboflavin and Its Derivates as Potential Photosensitizers in the Photodynamic Treatment of Skin Cancers. Cells 2023; 12:2304. [PMID: 37759526 PMCID: PMC10528563 DOI: 10.3390/cells12182304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Riboflavin, a water-soluble vitamin B2, possesses unique biological and physicochemical properties. Its photosensitizing properties make it suitable for various biological applications, such as pathogen inactivation and photodynamic therapy. However, the effectiveness of riboflavin as a photosensitizer is hindered by its degradation upon exposure to light. The review aims to highlight the significance of riboflavin and its derivatives as potential photosensitizers for use in photodynamic therapy. Additionally, a concise overview of photodynamic therapy and utilization of blue light in dermatology is provided, as well as the photochemistry and photobiophysics of riboflavin and its derivatives. Particular emphasis is given to the latest findings on the use of acetylated 3-methyltetraacetyl-riboflavin derivative (3MeTARF) in photodynamic therapy.
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Affiliation(s)
- Małgorzata Insińska-Rak
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland; (M.I.-R.); (M.S.)
| | - Marek Sikorski
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland; (M.I.-R.); (M.S.)
| | - Agnieszka Wolnicka-Glubisz
- Department of Biophysics and Cancer Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland
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Golczak A, Prukała D, Sikorska E, Gierszewski M, Cherkas V, Kwiatek D, Kubiak A, Varma N, Pędziński T, Murphree S, Cibulka R, Mrówczyńska L, Kolanowski JL, Sikorski M. Tetramethylalloxazines as efficient singlet oxygen photosensitizers and potential redox-sensitive agents. Sci Rep 2023; 13:13426. [PMID: 37591918 PMCID: PMC10435492 DOI: 10.1038/s41598-023-40536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/12/2023] [Indexed: 08/19/2023] Open
Abstract
Tetramethylalloxazines (TMeAll) have been found to have a high quantum yield of singlet oxygen generation when used as photosensitizers. Their electronic structure and transition energies (S0 → Si, S0 → Ti, T1 → Ti) were calculated using DFT and TD-DFT methods and compared to experimental absorption spectra. Generally, TMeAll display an energy diagram similar to other derivatives belonging to the alloxazine class of compounds, namely π,π* transitions are accompanied by closely located n,π* transitions. Photophysical data such as quantum yields of fluorescence, fluorescence lifetimes, and nonradiative rate constants were also studied in methanol (MeOH), acetonitrile (ACN), and 1,2-dichloroethane (DCE). The transient absorption spectra were also analyzed. To assess cytotoxicity of new compounds, a hemolytic assay was performed using human red blood cells (RBC) in vitro. Subsequently, fluorescence lifetime imaging experiments (FLIM) were performed on RBC under physiological and oxidative stress conditions alone or in the presence of TMeAll allowing for pinpointing changes caused by those compounds on the intracellular environment of these cells.
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Affiliation(s)
- Anna Golczak
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland
| | - Dorota Prukała
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland
| | - Ewa Sikorska
- Poznań University of Economics and Business, Al. Niepodległości 10, 61-875, Poznan, Poland
| | - Mateusz Gierszewski
- Faculty of Physics, Adam Mickiewicz University, Uniwersytetu Poznańskiego 2, 61-614, Poznan, Poland
| | - Volodymyr Cherkas
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Dorota Kwiatek
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Adam Kubiak
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland
| | - Naisargi Varma
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland
| | - Tomasz Pędziński
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland
| | - Shaun Murphree
- Department of Chemistry, Allegheny College, 520 N. Main Street, Meadville, PA, USA
| | - Radek Cibulka
- Department of Organic Chemistry, University of Chemistry and Technology, Prague, Technicka 5, 16628, Prague 6, Czech Republic.
| | - Lucyna Mrówczyńska
- Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614, Poznan, Poland.
| | - Jacek Lukasz Kolanowski
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland.
| | - Marek Sikorski
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614, Poznan, Poland.
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Musa M, Zeppieri M, Atuanya GN, Enaholo ES, Topah EK, Ojo OM, Salati C. Nutritional Factors: Benefits in Glaucoma and Ophthalmologic Pathologies. Life (Basel) 2023; 13:1120. [PMID: 37240765 PMCID: PMC10222847 DOI: 10.3390/life13051120] [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: 03/07/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Edo State, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | | | | | - Efioshiomoshi Kings Topah
- Department of Optometry, Faculty of Allied Health Sciences, College of Health Sciences Bayero University, Kano 700006, Kano State, Nigeria
| | - Oluwasola Michael Ojo
- School of Optometry and Vision Sciences, College of Health Sciences, University of Ilorin, Ilorin 240003, Kwara State, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Long XX, Xie AD, Yang P, Xie J, Chen XL, Huang YD, Zhang LP, Peng XB. Effect of various types of photodynamic therapy on inflammatory and non-inflammatory lesions in patients with acne: A network meta-analysis of randomized controlled trials. Photodiagnosis Photodyn Ther 2023; 42:103365. [PMID: 36842473 DOI: 10.1016/j.pdpdt.2023.103365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Recent studies have demonstrated that photodynamic therapy (PDT) is safe and effective in treating acne vulgaris. The present study aimed to evaluate various PDTs on inflammatory and non-inflammatory lesions in patients with acne by a network meta-analysis (NMA) of randomized controlled trials (RCTs). METHODS The researchers of this paper searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to March 2022 to identify suitable RCTs. The included studies were evaluated for methodological quality using the Cochrane bias risk assessment tool. Twenty-one RCTs were included, with a total sample size of 898 participants. RESULTS Network meta-analysis (NMA) revealed that indocyanine green (ICG) + near-infrared (NIR) diode laser, ICG+830 nm light-emitting diode (LED), indole-3-acetic acid (IAA) + 520 nm LED, and 5-aminolevulinic acid (ALA) + sunlight demonstrated obvious curative effects in patients with acne vulgaris. Importantly, ICG+NIR diode laser provided the greatest improvement in both inflammatory and non-inflammatory acne lesions (surface under the cumulative ranking curve [SUCRA]: 84.4% and 93.5%, respectively). CONCLUSIONS Based on the NWM and SUCRA ranking, ICG + NIR diode laser can be considered more effective in treating acne than the other PDTs of the RCTs. However, this conclusion should be interpreted with caution due to the limitations of the present study.
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Affiliation(s)
- Xin-Xin Long
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Ai-Di Xie
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Peng Yang
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Jie Xie
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Xiao-Li Chen
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Yun-Di Huang
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Li-Ping Zhang
- Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China
| | - Xue-Biao Peng
- Department of Dermatology, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Baiyun District, Guangzhou, Guangdong 510515, China; Department of Dermatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No.28, Innovation Avenue, Yongning Street, Zengcheng District, Guangzhou, Guangdong 511356, China.
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7
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Murotomi K, Umeno A, Shichiri M, Tanito M, Yoshida Y. Significance of Singlet Oxygen Molecule in Pathologies. Int J Mol Sci 2023; 24:ijms24032739. [PMID: 36769060 PMCID: PMC9917472 DOI: 10.3390/ijms24032739] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Reactive oxygen species, including singlet oxygen, play an important role in the onset and progression of disease, as well as in aging. Singlet oxygen can be formed non-enzymatically by chemical, photochemical, and electron transfer reactions, or as a byproduct of endogenous enzymatic reactions in phagocytosis during inflammation. The imbalance of antioxidant enzymes and antioxidant networks with the generation of singlet oxygen increases oxidative stress, resulting in the undesirable oxidation and modification of biomolecules, such as proteins, DNA, and lipids. This review describes the molecular mechanisms of singlet oxygen production in vivo and methods for the evaluation of damage induced by singlet oxygen. The involvement of singlet oxygen in the pathogenesis of skin and eye diseases is also discussed from the biomolecular perspective. We also present our findings on lipid oxidation products derived from singlet oxygen-mediated oxidation in glaucoma, early diabetes patients, and a mouse model of bronchial asthma. Even in these diseases, oxidation products due to singlet oxygen have not been measured clinically. This review discusses their potential as biomarkers for diagnosis. Recent developments in singlet oxygen scavengers such as carotenoids, which can be utilized to prevent the onset and progression of disease, are also described.
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Affiliation(s)
- Kazutoshi Murotomi
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8566, Japan
| | - Aya Umeno
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
| | - Mototada Shichiri
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ikeda 563-8577, Japan
- Correspondence: ; Tel.: +81-72-751-8234
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
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de Paiva ADCM, Ferreira MDC, da Fonseca ADS. Photodynamic therapy for treatment of bacterial keratitis. Photodiagnosis Photodyn Ther 2022; 37:102717. [PMID: 35021106 DOI: 10.1016/j.pdpdt.2022.102717] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/23/2021] [Accepted: 01/07/2022] [Indexed: 12/22/2022]
Abstract
Microbial keratitis is the main cause of corneal opacification and the fourth leading cause of blindness worldwide, with bacteria the major infectious agent. Recently, bacterial keratitis has become a serious threat due to routine use of antibiotics leading to selection of resistant and multidrug-resistant bacteria strains. New approaches for treatment of bacterial keratitis are necessary to outcome the increasing antibiotic resistance. Antimicrobial photodynamic therapy is based on three agents: photosensitizer, oxygen, and light radiation. This therapy has been successful for treatment of infections in different tissues and organs as well as against different type of infectious agents and no resistance development. Also, new photosensitizers are being developed that has increased the spectrum of therapeutic protocols for treatment of a number of infectious diseases. Thus, antimicrobial photodynamic therapy has an extraordinary potential for treatment of those bacterial keratitis cases that actually are not solved by traditional antibiotic therapy.
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Affiliation(s)
- Alexandre de Carvalho Mendes de Paiva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rua Mariz e Barros, 775, Maracanã, Rio de Janeiro 20270002, Brazil
| | - Michelle da Costa Ferreira
- Faculdade de Odontologia, Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 157, Vila Isabel, Rio de Janeiro 20551030, Brazil
| | - Adenilson de Souza da Fonseca
- Departamento de Ciências Fisiológicas, Instituto Biomédico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro 20211040, Brazil; Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 87 fundos, 4º andar, Vila Isabel, Rio de Janeiro 20551030, Brazil; Centro de Ciências da Saúde, Centro Universitário Serra dos Órgãos, Avenida Alberto Torres, 111, Teresópolis, Rio de Janeiro 25964004, Brazil.
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9
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The Use of Lasers and Light Devices in Acne Management: An Update. Am J Clin Dermatol 2021; 22:785-800. [PMID: 34287769 DOI: 10.1007/s40257-021-00624-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
Acne vulgaris is a disease of the pilosebaceous unit and the most common inflammatory dermatosis worldwide. It is also associated with significant economic burden. Limitations of conventional topical and systemic treatments include long treatment course, intolerable adverse effects, antibiotic resistance, and patient compliance. Therefore, laser and light-based interventions present as alternative options over the past decade and have been used in combination with conventional pharmacological therapies and other physical modalities. An updated overview on the use of lasers and light-based devices in acne management is presented to help clinicians understand the safety and efficacy of these treatment options. The effectiveness of neodymium:yttrium aluminum garnet (Nd:YAG) for treating acne is supported by more high-level studies compared with other laser devices. There is limited evidence to support the use of CO2 lasers, potassium titanyl phosphate lasers, and 1565-nm non-ablative fractional lasers for treating acne. Among light devices, photodynamic therapy is the most studied, showing higher efficacies than some of the conventional topical and oral acne therapies. Intense-pulsed light and blue light therapies also show favorable outcomes. A limitation is that most studies are non-randomized and lack a control group, and report on a variety of device settings, treatment regimens, and outcome measures, making it challenging to summarize and generalize findings. Although the use of laser and light devices to treat acne is promising, further work with randomized controlled study designs and larger sample sizes will provide improved guidance on the application of these modalities.
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Zeitouni NC, Bhatia N, Ceilley RI, Cohen JL, Del Rosso JQ, Moore AY, Munavalli G, Pariser DM, Schlesinger T, Siegel DM, Willey A, Goldman MP. Photodynamic Therapy with 5-aminolevulinic Acid 10% Gel and Red Light for the Treatment of Actinic Keratosis, Nonmelanoma Skin Cancers, and Acne: Current Evidence and Best Practices. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:E53-E65. [PMID: 34976292 PMCID: PMC8711613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Photodynamic therapy (PDT) can be an effective treatment for actinic keratosis (AK) as well as selected non-melanoma skin cancers (NMSCs), such as Bowen's disease and superficial basal cell carcinoma. PDT has also demonstrated effectiveness in the management of acne vulgaris. Results from controlled clinical trials have shown the safety and efficacy of PDT for these conditions with the use of different photosensitizers and a wide range of light sources. PDT has been employed effectively as monotherapy and in combination with other topicals and alternate light or laser energy therapies. This article provides expert practical guidance for the use of the newest 5-aminolevulinic acid (ALA) product (ALA 10% gel) plus red light as monotherapy for AKs, NMSC, and acne. Here, information from clinical guidelines and a summary of supporting evidence is provided for each cutaneous condition. The authors also provide detailed guidance for employing ALA 10% gel, a photosensitizer precursor, for each of these applications.
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Affiliation(s)
- Nathalie C Zeitouni
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Neal Bhatia
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Roger I Ceilley
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Joel L Cohen
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - James Q Del Rosso
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Angela Y Moore
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Gilly Munavalli
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - David M Pariser
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Todd Schlesinger
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Daniel M Siegel
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Andrea Willey
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
| | - Mitchel P Goldman
- Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona
- Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California
- Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa
- Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas
- Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
- Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia
- Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York
- Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York
- Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California
- Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California
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11
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Guo K, Zhu D, Lu Z, Pan Y, Deng H. Effect of minocycline hydrochloride combined with photodynamic therapy on skin barrier function of patients with acne. Am J Transl Res 2021; 13:8427-8432. [PMID: 34377339 PMCID: PMC8340184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 03/28/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the effects of minocycline hydrochloride combined with photodynamic therapy on skin barrier function of patients with acne. METHODS Eighty-eight acne patients admitted to our hospital were randomized into research group (n=44, photodynamic therapy on the basis of minocycline hydrochloride) and control group (n=44, minocycline hydrochloride). The clinical efficacy, skin barrier function indexes (transdermal water loss (TEWL), stratum corneum water content, pH value), scores of GAGS and Acne-QOL, cosmetic satisfaction and adverse reaction rates of the two groups were compared. RESULTS The total effective rate of research group was higher than that of control group (P<0.05). After treatment, TEWL, cuticle water content and pH value were improved compared with those before treatment, and the research group was superior to the control group (all P<0.05). After treatment, the GAGS scores of both groups were lower than those before treatment, and the research group was lower than that of the control group (all P<0.05). The cosmetic satisfaction in the research group was higher than that in the control group (P<0.05). There was no marked difference in the incidence of adverse reactions between the two groups (P>0.05). After treatment, the quality of life scores of patients were higher than before treatment, and the research group was higher than that of the control group (all P<0.05). CONCLUSION Minocycline hydrochloride combined with photodynamic therapy can effectively improve the skin barrier function of patients, relieve clinical symptoms, and enhance the overall efficacy and quality of life. It is also safe and patients are highly satisfied with the cosmetic effect.
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Affiliation(s)
- Keye Guo
- Department of Dermatology, Shengzhou People’s HospitalShaoxing, Zhejiang Province, China
| | - Dingxian Zhu
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, Zhejiang Province, China
| | - Zhongming Lu
- Department of Dermatology, Shengzhou People’s HospitalShaoxing, Zhejiang Province, China
| | - Yunlei Pan
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, Zhejiang Province, China
| | - Huazhou Deng
- Department of Dermatology, Shengzhou People’s HospitalShaoxing, Zhejiang Province, China
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