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Di Bartolomeo L, Altavilla D, Vaccaro M, Vaccaro F, Squadrito V, Squadrito F, Borgia F. Photodynamic therapy in pediatric age: Current applications and future trends. Front Pharmacol 2022; 13:879380. [PMID: 36052131 PMCID: PMC9424823 DOI: 10.3389/fphar.2022.879380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Photodynamic therapy (PDT) is a photochemotherapy based on local application of a photosensitive compound and subsequent exposure to a light source of adequate wavelength. It is a non-invasive therapeutic procedure widely used in oncodermatology for treatment of numerous skin cancers, but in the last years its use has been gradually extended to an increasing list of skin diseases of both infectious and inflammatory nature. Although PDT is proven as a safe and effective therapeutic option in adults, its use is not well standardized in the pediatric population. In this review, we will focus on clinical applications, mechanisms of action, protocols, and adverse events in children and adolescents. Most of pediatric experiences concerned treatment of skin cancers in Gorlin syndrome and xeroderma pigmentosum, acne vulgaris, and viral warts, but other applications emerged, such as cutaneous lymphoma and pseudo-lymphomas, necrobiosis lipoidica, hidradenitis suppurativa, dissecting cellulitis, leishmaniasis, angiofibromas, verrucous epidermal nevus, and linear porokeratosis. In these pediatric diseases, PDT appeared as an effective therapeutic alternative. The results on vitiligo were limited and not fully encouraging. Although highly versatile, PDT is not a therapy for all skin diseases, and a deeper knowledge of its mechanisms of action is required to better define its spectrum of action and safety in pediatric patients.
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Affiliation(s)
- Luca Di Bartolomeo
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
- *Correspondence: Luca Di Bartolomeo,
| | - Domenica Altavilla
- Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Federico Vaccaro
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Violetta Squadrito
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi, Pediatryˮ, University of Messina, Messina, Italy
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
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Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon 2020; 67:101103. [PMID: 33041056 DOI: 10.1016/j.disamonth.2020.101103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.
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Bonamonte D, De Marco A, Giuffrida R, Conforti C, Barlusconi C, Foti C, Romita P. Topical antibiotics in the dermatological clinical practice: Indications, efficacy, and adverse effects. Dermatol Ther 2020; 33:e13824. [PMID: 32531105 DOI: 10.1111/dth.13824] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/26/2020] [Accepted: 06/10/2020] [Indexed: 12/13/2022]
Abstract
Topical antibiotic therapy is a central component of patient management for several skin conditions, including acne, hidradenitis suppurativa, rosacea, impetigo or other superinfected dermatitis, and prevention of wound infections. Moreover, particular situations, such as skin diseases of bacterial origin in pregnancy and infants often warrant topical therapy. However, the occurrence of local delayed hypersensitivity reactions and the rising rate of antibiotic resistance are becoming great challenges faced by many dermatologists today. This narrative review provides an overview of the main topical antibiotics used in dermatology, focusing on their clinical role in the most common dermatological indications. For this purpose, a review of MEDLINE and PubMed for pertinent, scientific, and clinical publications until March 2020 was performed. Only articles published in the English language were included.
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Affiliation(s)
- Domenico Bonamonte
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Aurora De Marco
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Claudio Conforti
- Dermatology Clinic, Hospital Maggiore of Trieste, University of Trieste, Italy
| | - Chiara Barlusconi
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Paolo Romita
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
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Poli F, Auffret N, Leccia MT, Claudel JP, Dréno B. Truncal acne, what do we know? J Eur Acad Dermatol Venereol 2020; 34:2241-2246. [PMID: 32421879 DOI: 10.1111/jdv.16634] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/30/2020] [Indexed: 12/21/2022]
Abstract
Truncal acne is frequently overlooked in dermatological practice, even though it may result in scars and impact on self-esteem and body image. Therefore, it is important to identify the disease early in order to initiate treatment in time and, thus, to prevent it from worsening and resulting in physical and psychological sequelae. The aim of this review is to provide an overview of what is currently known about truncal acne, its prevalence, aetiology and physiopathology, how its severity is currently evaluated, how to differentiate it from other skin afflictions and current treatment options. A review of literature considering the issue of truncal acne published up to 2019 and available from PubMed was conducted, and in total, 76 articles were selected from PubMed. Currently, only little information about truncal acne is available. Considered as having the same pathophysiology as facial acne, the clinical picture and treatment response seem to differ. Specific acne severity grading systems and quality of life questionnaires as well as a specific treatment algorithm are still lacking. Filling this gap should allow clinicians to assess truncal acne in the best possible way, choosing suitable treatment options, helping patients to improve treatment adherence and quality of life and finally allowing a better management of truncal acne. In conclusion, more knowledge is required to treat more efficiently truncal acne.
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Affiliation(s)
- F Poli
- Private Practice, Paris, France
| | | | - M-T Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | | | - B Dréno
- UF dermato-cancérologie, CHU Nantes-Hôtel-Dieu, Inserm U1232, CIC Biothérapie Inserm 05031, Nantes, France
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Conforti C, Chello C, Giuffrida R, di Meo N, Zalaudek I, Dianzani C. An overview of treatment options for mild‐to‐moderate acne based on American Academy of Dermatology, European Academy of Dermatology and Venereology, and Italian Society of Dermatology and Venereology guidelines. Dermatol Ther 2020; 33:e13548. [DOI: 10.1111/dth.13548] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Claudio Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste Trieste Italy
| | - Camilla Chello
- Dermatology Section, Department of Plastic, Reconstructive and Cosmetic Surgery Campus Biomedico University Hospital Rome Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology University of Messina Messina Italy
| | - Nicola di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste Trieste Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste Trieste Italy
| | - Caterina Dianzani
- Dermatology Section, Department of Plastic, Reconstructive and Cosmetic Surgery Campus Biomedico University Hospital Rome Italy
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