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Twigg E, Roberts E, Sharp A, Iraba J, Chapa P, Freeland H, Mavura D. Daylight photodynamic therapy as a treatment for actinic field change in patients diagnosed with oculocutaneous albinism in sub-Saharan Africa. Clin Exp Dermatol 2024; 49:484-490. [PMID: 37995284 DOI: 10.1093/ced/llad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Oculocutaneous albinism (OCA) is a genetically inherited condition, whereby melanin is reduced or absent in the skin. A lack of melanin predisposes people to actinic damage and skin malignancies. In Tanzania, a resource-limited country, the treatment of choice for precancerous skin lesions is cryotherapy. OBJECTIVES To investigate whether daylight photodynamic therapy (dPDT) is a safe and well-tolerated treatment for actinic field change in the OCA population in Tanzania. METHODS Twelve participants with actinic damage were recruited from a Standing Voice skin surveillance clinic and treated with dPDT. Study participants completed tolerability and acceptability questionnaires at day 5 and 3 months after treatment. A dermatologist assessed their clinical response to dPDT at 3 months. RESULTS dPDT was well-tolerated and acceptable to the majority of patients. Actinic damage was reduced by 25-90%. No skin cancers developed during the treatment. CONCLUSIONS This pilot study suggests that dPDT is a safe and tolerable treatment for actinic damage in people with OCA in Tanzania. Further work is required to compare the efficacy of dPDT against other topical therapies for actinic field change.
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Affiliation(s)
- Emily Twigg
- Department of Dermatology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elizabeth Roberts
- Department of Dermatology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Andrew Sharp
- Department of Dermatology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Peter Chapa
- Dodoma Regional Referral Hospital, Dodoma, Tanzania
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Kimura E, Miura M. Giant retinal pigment epithelial tear following photodynamic therapy for the bullous variant of central serous chorioretinopathy: A case report. Medicine (Baltimore) 2024; 103:e37855. [PMID: 38640292 PMCID: PMC11029976 DOI: 10.1097/md.0000000000037855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/28/2024] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The bullous variant of central serous chorioretinopathy (CSC) is a severe form of chronic CSC. Patients with the bullous variant of CSC have an increased risk of experiencing multiple pigment epithelial detachments (PEDs) and retinal pigment epithelium (RPE) tears. Photodynamic therapy (PDT) is a treatment for the bullous variant of CSC. RPE tear is a possible postoperative complication of PDT for eyes with PEDs. To our knowledge, no cases of giant RPE tears following PDT for the bullous variant of CSC have been reported previously. This case report presents the first instance of a giant RPE tear after half-time PDT for the bullous variant of CSC, accompanied by a series of images depicting the tear development. PATIENT CONCERNS A 63-year-old male patient presented with rapidly deteriorating vision in his left eye over a 3-month period. He also reported a previous episode of vision loss in his right eye 2 years prior. Best-corrected visual acuity (BCVA) in the left eye was 0.2. DIAGNOSIS The right eye was diagnosed with chronic non-bullous CSC, while the left eye was diagnosed with the bullous variant of CSC with a large PED. INTERVENTIONS Half-time PDT was administered to the left eye. OUTCOMES One month after half-time PDT, a giant RPE tear exceeding 3 clock-hours in size was confirmed in the lower temporal quadrant of the left eye. Three months after the initial half-time PDT, a second half-time PDT was performed owing to recurrent retinal detachment. Two months after the second half-time PDT, the retinal detachment resolved, and BCVA improved to 0.4, 6 months after the second half-time PDT. LESSONS In cases where the bullous variant of CSC is complicated by extensive PED, clinicians should consider the potential development of a giant RPE tear as a treatment complication.
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Affiliation(s)
- Eri Kimura
- Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Inashiki, Ibaraki, Japan
| | - Masahiro Miura
- Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Inashiki, Ibaraki, Japan
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Sjöholm A, Claeson M, Paoli J, Heckemann B. Exploring Patient Pain Experiences during and after Conventional Red Light and Simulated Daylight Photodynamic Therapy for Actinic Keratosis: A Qualitative Interview Study. Acta Derm Venereol 2024; 104:adv19459. [PMID: 38596905 PMCID: PMC11022748 DOI: 10.2340/actadv.v104.19459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Simulated daylight photodynamic therapy is a relatively new and potentially less painful alternative to conventional red light photodynamic therapy for actinic keratosis. Qualitative research exploring patient experiences of pain and skin reactions during these treatments is scarce. To address this, semi-structured interviews were conducted of 10 patients aged 60-81 years with symmetrically distributed actinic keratoses 4 weeks after split-face treatment with conventional red light photodynamic therapy and simulated daylight photodynamic therapy. The participants were recruited from an ongoing clinical randomized trial. Interviews (median length 35 min) were conducted between June 2022 and January 2023, audio-recorded, transcribed verbatim, and analysed qualitatively using content analysis, as described by Graneheim and Lundman. Participants reported that conventional red light photodynamic therapy was very painful during illumination and transiently painful in the post-treatment period, while simulated daylight photodynamic therapy was almost painless during illumination and led to minor post-treatment pain. Also, skin reactions were more intense and longer-lasting with conventional red light photodynamic therapy than with simulated daylight photodynamic therapy. Most participants expressed a treatment preference for simulated daylight photodynamic therapy but had reservations about its unestablished long-term effectiveness. This study underscores the considerable pain associated with conventional red light photodynamic therapy, and the pivotal importance of shared decision-making when selecting the most appropriate treatment.
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Affiliation(s)
- Alexandra Sjöholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden.
| | - Magdalena Claeson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Birgit Heckemann
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Anaesthetics and Intensive Care, Gothenburg, Sweden
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Dongre P, Bevara A, Deshmukh R, Vaddavalli PK. Central Toxic Keratopathy After Collagen Cross-Linking: A Case Series. Cornea 2024; 43:446-451. [PMID: 38016022 DOI: 10.1097/ico.0000000000003438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/30/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE The aim of this study was to report a case series of central toxic keratopathy (CTK) after collagen cross-linking (CXL) in keratoconus. METHODS This is a retrospective case series between January 2020 and September 2021. In this period, CXL was performed for progressive keratoconus in 964 eyes. CXL was performed using the epithelium-off accelerated protocol in all patients with a riboflavin soak time of 20 minutes and a UVA light exposure of 9 mW for 10 minutes using the Avedro KXL (Glaukos Inc, Aliso Viejo, CA) cross-linking system. RESULTS Twelve of 964 eyes (1.2%) developed CTK within 1 week of CXL. All patients presented with well-circumscribed, central disciform haze that was broader in the anterior stroma and narrower in the posterior stroma. We noted initial flattening in keratometry up to 3 months post-CXL in these patients, which gradually steepened over 12 months, but did not reach preoperative levels. We also noted exuberant flattening in pachymetry in the first 3 months, which improved over 12 months. There was a statistically significant decrease in pachymetry in patients who developed CTK at 3 and 12 months postoperatively when compared to patients who underwent CXL but did not develop CTK. CONCLUSIONS Several reports of CTK postrefractive surgery have been described previously. However, the association of CXL in the development of CTK has not been described previously. Here, we elucidated the clinical features of CTK after CXL and how it differs from corneal scarring or haze that occurs post-CXL.
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Affiliation(s)
- Pankaj Dongre
- Department of Cataract and Refractive Surgery, L V Prasad Eye Institute, Vishakapatnam, India
| | - Akhil Bevara
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India; and
| | - Rashmi Deshmukh
- Department of Cataract and Refractive Surgery, L V Prasad Eye Institute, Hyderabad, India
| | - Pravin K Vaddavalli
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India; and
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Anwar A, Khan NA, Alharbi AM, Alhazmi A, Siddiqui R. Applications of photodynamic therapy in keratitis. Int Ophthalmol 2024; 44:140. [PMID: 38491335 DOI: 10.1007/s10792-024-03062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/16/2024] [Indexed: 03/18/2024]
Abstract
Keratitis is corneal inflammatory disease which may be caused by several reason such as an injury, allergy, as well as a microbial infection. Besides these, overexposure to ultraviolet light and unhygienic practice of contact lenses are also associated with keratitis. Based on the cause of keratitis, different lines of treatments are recommended. Photodynamic therapy is a promising approach that utilizes light activated compounds to instigate either killing or healing mechanism to treat various diseases including both communicable and non-communicable diseases. This review focuses on clinically-important patent applications and the recent literature for the use of photodynamic therapy against keratitis.
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Affiliation(s)
- Ayaz Anwar
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Naveed Ahmed Khan
- Microbiota Research Center, Istinye University, 34010, Istanbul, Turkey.
| | - Ahmad M Alharbi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
| | - Ayman Alhazmi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
| | - Ruqaiyyah Siddiqui
- Microbiota Research Center, Istinye University, 34010, Istanbul, Turkey
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, EH14 4AS, UK
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Ming J, Yang Z, Wang T, Wang J, Zeng X. Photodynamic therapy for refractory erosive oral lichen planus: a case series study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e41-e44. [PMID: 38278673 DOI: 10.1016/j.oooo.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 01/28/2024]
Abstract
Oral lichen planus is a chronic inflammatory disease that occurs on the oral mucosa and is an oral potentially malignant disease. Treatment of oral lichen planus aims to promote healing of the erosion, relieve pain, reduce recurrence of the erosion, and prevent canceration. Corticosteroids are the first line of treatment for oral lichen planus. Refractory oral lichen planus is a clinical classification of oral lichen planus that has not responded to corticosteroid treatment for more than 2 months. Topical 5-aminolevulinic acid-mediated photodynamic therapy is an innovative and effective treatment for potentially malignant oral diseases and has been reported as an alternative treatment to conventional therapies for oral lichen planus. On this basis, we report 3 cases of refractory erosive oral lichen planus in which persistent erosive lesions healed after topical application of 5-aminolevulinic acid-mediated photodynamic therapy without any adverse effects or any signs of recurrence. Topical 5-aminolevulinic acid-mediated photodynamic therapy will become an effective clinical treatment for refractory erosive oral lichen planus.
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Affiliation(s)
- Jieyu Ming
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management & Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhixin Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management & Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tianqing Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management & Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiongke Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management & Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Xin Zeng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management & Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Bahrami R, Pourhajibagher M, Gharibpour F. Antimicrobial photodynamic therapy for the management of gingivitis and white spot lesions in fixed orthodontic patients: A systematic review. Int Orthod 2024; 22:100821. [PMID: 37992475 DOI: 10.1016/j.ortho.2023.100821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 11/24/2023]
Abstract
AIM We conducted this review to evaluate the safety and efficacy of antimicrobial photodynamic therapy (aPDT) for the management of gingivitis and white spot lesions (WSLs) in fixed orthodontic patients. METHODS The PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases were searched for randomized controlled trials and clinical trials assessing the clinical effectiveness of aPDT for the management of gingivitis and WSLs in fixed orthodontic patients without time limitation. Primary outcomes were the changes in clinical parameters such as DIAGNOdent, plaque index (PI), bleeding on probing (BOP), and gingival index (GI). Secondary outcomes included measurements of microbial and inflammatory factors, such as cytokine levels (tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]), and bacterial counts. RESULTS Our search yielded a total of 12 studies that met the inclusion criteria. Among the 11 studies that evaluated gingivitis, the majority employed a diode laser (670nm, 150 mW, 22J/cm2, 60seconds) as the light source and methylene blue at a concentration of 0.0005% (applied for 3minutes) as the photosensitizer in a single treatment session. The included studies reported positive effects of aPDT on gingivitis management, with more improvements observed in PI, BOP, and GI following aPDT treatment. Additionally, aPDT was found to reduce the counts of periopathogens such as Porphyromonas gingivalis, as well as inflammatory factors (TNF-α, IL-1β, and IL-6). Two studies demonstrated that aPDT, particularly when administered in multiple sessions, effectively controlled the extent of WSLs during orthodontic treatment and yielded favorable outcomes that persisted for several months after treatment. CONCLUSION Based on the available evidence, aPDT appears to be a safe and effective treatment option for managing WSLs and gingivitis in patients with fixed orthodontic appliances. However, further high-quality RCTs are necessary to investigate the impact of potential confounding factors on the efficacy of aPDT.
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Affiliation(s)
- Rashin Bahrami
- Dental Sciences Research Center, Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Gharibpour
- Dental Sciences Research Center, Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
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Xia YX, Hu YY, Xia Y, Li DS. Pyogenic Granuloma After Treatment of Port-Wine Stain With Hemoporfin-Mediated Photodynamic Therapy. Dermatol Surg 2024; 50:302-303. [PMID: 38048227 DOI: 10.1097/dss.0000000000004049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Affiliation(s)
- Yu-Xin Xia
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Infectious Skin Diseases of Hubei Province, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Yan Hu
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Xia
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dong-Sheng Li
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Infectious Skin Diseases of Hubei Province, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hu Y, Cheng Y, Jie W. Analysis of the effectiveness of PDT with 5-aminolevulinic acid in comparison to blue/red light combined with intralesional triamcinolone injection in treatment of severe inflammatory acne: A retrospective study. J Cosmet Dermatol 2024; 23:849-856. [PMID: 37881149 DOI: 10.1111/jocd.16045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/19/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE In this study, the therapeutic effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in comparison to blue/red light combined with intralesional triamcinolone injection for severe inflammatory acne was evaluated and analyzed. METHODS One hundred and four cases of severe inflammatory acne were analyzed in this study. They were divided into two groups as control and observation groups, 52 cases in each group. The control group (group A) received red and blue light combined with triamcinolone injection and lidocaine injection (1:4), while the observation group (Group B) was treated with ALA-PDT. Finally, the therapeutic effect and the occurrence of adverse reactions were compared between the two groups. RESULTS After 2, 4 and 6 weeks, the effectiveness rates of group B was 28.85%, 75.00%, and 86.54%, respectively while it was 9.62%, 51.92%, and 69.23%, respectively in group A. The difference between A and B was statistically remarkable (χ2 = 6.1905, 5.9713, 4.5217, p = 0.0128, 0.0145, 0.0335 at p < 0.05). In addition, the incidence of adverse reactions in B was 5.77%, lower than A (32.69%). This difference between A and B was statistically remarkable (χ2 = 12.1333, p = 0.0005). After 2, 4, and 6 weeks of treatment, the number of residual lesions in the group B group was remarkably lower than group A (p < 0.01). There was remarkable difference in the incidence of pain, burning sensation, pigmentation and erythema between the two groups. CONCLUSIONS The therapeutic effect of ALA-PDT in the treatment of severe acne is better than red blue light combined with triamcinolone injection and lidocaine injection. In addition, ALA-PDT has an ideal effect in the treatment of severe acne.
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Affiliation(s)
- Yi Hu
- Department of Dermatology and Venereology, The Eighth Hospital of Wuhan, Wuhan, China
| | - Yang Cheng
- Dermatological Department, Wuhan No.1 Hospital, Wuhan, China
| | - Wang Jie
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Wang Y, Tang H, Wang K, Zhao Y, Xu J, Fan Y. Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients. BMC Oral Health 2024; 24:9. [PMID: 38172857 PMCID: PMC10765792 DOI: 10.1186/s12903-023-03791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Topical photodynamic therapy (PDT) has demonstrated encouraging results in the treatment of oral leukoplakia (OLK). However, data on the clinical efficacy of PDT in Chinese patients with OLK are still limited. METHODS Fifty patients diagnosed with OLK were enrolled, including patients with various dysplastic tissues. All patients received topical PDT with 5-aminolevulinic acid (5-ALA) as a photosensitizer. Clinical efficacy was evaluated 4 weeks after treatment. Follow-up was performed every 3 months during the first year and every 6 months during the second year. RESULTS The overall response rate was 68% (34/50): 12% (n = 6) complete and 56% (n = 28) partial responses. Aneuploidy was reduced in the patients with dysplastic lesions. Oral pain and local ulcers developed in 52% of the patients (n = 26). Patients with a long history of OLK including hyperplasia and dysplastic lesions, as well as those with non-homogenous lesions, were more likely to develop pain and ulcer. During follow-up, the recurrence rate of hyperplasia and dysplastic lesions was 32% (n = 16) and the malignant transformation rate of dysplastic lesions was 4% (n = 2). Lesions on the buccal mucosa were associated with recurrence (P = 0.044; OR: 0.108, 95% CI: 0.013-0.915). CONCLUSION Topical 5-ALA-mediated PDT is an effective treatment for OLK, particularly for homogenous leukoplakia, with few side effects. The buccal mucosa may be a protective factor that can reduce recurrence.
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Affiliation(s)
- Yanting Wang
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Haonan Tang
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Keyi Wang
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Yuping Zhao
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Juanyong Xu
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Yuan Fan
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.
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Fernández-Vigo JI, Valverde-Megías A, García-Caride S, Burgos-Blasco B, Oribio-Quinto C, Donate-López J. PHOTODYNAMIC THERAPY-INDUCED ACUTE EXUDATIVE MACULOPATHY IN A CASE SERIES OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA. Retina 2024; 44:56-62. [PMID: 37603591 DOI: 10.1097/iae.0000000000003915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
PURPOSE To describe the incidence, features, and clinical outcomes of photodynamic therapy-induced acute exudative maculopathy (PAEM) in circumscribed choroidal hemangioma. METHODS Prospective series of 10 patients who underwent standard-fluence photodynamic therapy for circumscribed choroidal hemangioma. Best-corrected visual acuity in the Early Treatment Diabetic Retinopathy Score and swept-source optical coherence tomography were performed before PDT and 3 days and 1 month after PDT. Central retinal thickness, circumscribed choroidal hemangioma retinal thickness, and subretinal fluid were measured. Photodynamic therapy-induced acute exudative maculopathy was considered as an increase ≥50 µ m in subretinal fluid or intraretinal fluid or the appearance of fibrin 3 days after photodynamic therapy. RESULTS Six men and four women were included; median age was 55 years (19-69 years). The incidence rate of PAEM was 7 of 10. Five PAEM patients showed an increase in intraretinal fluid, two in subretinal fluid, and one developed abundant fibrin. Median best-corrected visual acuity at baseline was 57.5 letters (5-76 letters) being stable at 1 month (64 letters; 5-80) ( P = 0.03). Median central retinal thickness increased from 516 µ m (262-1,265 µ m) to 664.5 µ m after 3 days and diminished to 245 µ m after 1 month (156-1,363) ( P ≤ 0.022). In 6 of 7 of PAEM, a complete resolution of the fluid was obtained. CONCLUSION Photodynamic therapy-induced acute exudative maculopathy was frequent in circumscribed choroidal hemangioma, although a favorable prognosis was observed in most cases.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - Alicia Valverde-Megías
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
| | - Sara García-Caride
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
| | - Carlos Oribio-Quinto
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
| | - Juan Donate-López
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; and
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12
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Nienstedt R, Schlagenhauff B, Rümmelein BC. [Treatment of therapy-resistant verruca plantaris with laser-assisted photodynamic therapy (PDT) with methyl aminolevulinate (MAL)]. Dermatologie (Heidelb) 2024; 75:71-74. [PMID: 37707554 DOI: 10.1007/s00105-023-05224-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 09/15/2023]
Abstract
Mosaic warts are a type of verruca vulgaris that occur almost exclusively on the soles of the feet. They are particularly known for their treatment resistance and high recurrence rate. Laser-assisted drug delivery (LADD) photodynamic therapy (PDT) with methyl aminolevulinate (MAL) offers a low pain treatment option with hardly any side effects in therapy-resistant cases of verruca plantaris. Pretreatment with an ablative fractional laser is especially important to obtain penetration of MAL through the human papillomavirus (HPV)-infected skin layer.
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Affiliation(s)
- Robert Nienstedt
- Dermacenter AG, Bahnhofstr. 15, 6403, Küssnacht am Rigi, Schweiz.
| | | | - Bettina C Rümmelein
- Dr. Rümmelein AG - House of Skin and Laser Medicine, Bürglistr. 1, 8802, Zürich, Schweiz
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Cheng C, Cheng W, Tian Q. The unintended consequences of photodynamic therapy in cholangiocarcinoma: A case of septic shock. Asian J Surg 2024; 47:562-563. [PMID: 37838551 DOI: 10.1016/j.asjsur.2023.09.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/22/2023] [Indexed: 10/16/2023] Open
Affiliation(s)
| | - Wen Cheng
- Department of Orthodontics, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Qing Tian
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China.
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14
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Albucker SJ, Lipner SR. The burning truth about light therapy: a retrospective analysis of the MAUDE database on UV phototherapy and photodynamic therapy complications 2013-2023. Arch Dermatol Res 2023; 316:51. [PMID: 38108883 DOI: 10.1007/s00403-023-02765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Phototherapy and photodynamic therapy (PDT) are ultraviolet light (UV) based therapies for patients with skin diseases, and are sometimes associated with potential adverse events (AE)s, including erythema, pain, pruritus, burns, and photoaging. METHODS We investigated UV phototherapy and PDT safety using the United States (US) Food and Drug Administration's (FDA)'s Manufacturer and User Facility Device Experience (MAUDE) database. The MAUDE database, including medical device reports (MDR)s informed by voluntary and obligatory reporters since 1991, was searched for AEs associated with UV phototherapy and PDT 1/1/91-3/1/23. RESULTS There were 59 UV phototherapy and 33 PDT related MDRs. Burns were the most common AE type for both phototherapy and PDT. The majority of phototherapy AEs occurred during 2021 (52.3%), and were significantly more likely to occur at home than in the clinic. Overall, 76.1% of MDRs associated with home light boxes were prescribed by online retailers, most of the MDRs (59.3%) mentioned that it is prohibited to sell phototherapy devices not prescribed by physicians, and only 8.5% noted poorly written home light box instructions. DISCUSSION The COVID-19 pandemic prohibited in-person light treatments, and social distancing requirements may have resulted in increased frequency of home-based light treatments. Hence, while at home treatment may be easier and more accessible, in-office physician supervised UV treatments are associated with less frequent AEs. Moreover, some phototherapy MDRs reported poorly written instructions accompanying the home light box, and some PDT MDRs documented patients receiving inadequate education regarding the procedure. With the rise of at-home treatment options and the ease of obtaining devices on the internet, it is physicians' duty to advise patients against self-treating with home light boxes without prescribed treatment regimens and educate patients that are considering home phototherapy to ensure safer patient experiences.
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Affiliation(s)
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, New York, NY, 10021, USA.
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15
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Zhang L, Yang Y, Wang B, Zhao Y, Wang P, Liu J, Yang J, Wu Y, Lv T, Wei Z, Liu X, Wang R, Wong H, Ju Q, Shi L, Wang X. Modified red light 5-aminolevulinic acid photodynamic therapy versus low-dose isotretinoin therapy for moderate to severe acne vulgaris: A prospective, randomized, multicenter study. J Am Acad Dermatol 2023; 89:1141-1148. [PMID: 37558093 DOI: 10.1016/j.jaad.2023.07.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Modified 5-aminolevulinic acid photodynamic therapy (M-PDT) and isotretinoin (ISO) are effective treatments for moderate to severe acne vulgaris. OBJECTIVE To evaluate the efficacy and adverse effects of M-PDT and ISO for moderate to severe acne vulgaris. METHODS A multicenter, randomized clinical trial was conducted with participants randomly assigned to the M-PDT group (up to 5 weekly sessions following manual comedone extraction) or the ISO group (oral ISO, 0.5 mg/kg/d for 6 months) and followed up to 6-months after therapy. RESULTS A total of 152 patients were allocated. The overall effective rates in the M-PDT group were significantly higher than the ISO group at 1 month (67.74% vs 10.26%), whereas the opposite was the case 1 month after treatment (75.81% vs 97.44%). Time to achieve 50% lesion improvement in the M-PDT group was significantly less than the ISO group (1 vs 8 weeks). Overall, 70.67% of the ISO group patients experienced systemic side effects such as hepatotoxicity, whereas side effects were skin-limited in the M-PDT group. LIMITATIONS Limitations of this study included relatively low numbers of participants and high withdrawal rate. CONCLUSION M-PDT offers a more rapid onset of improvement, comparable overall efficacy, good tolerability, and comparable durability of response compared with ISO.
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Affiliation(s)
- Linglin Zhang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Yutong Yang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan; Department of Dermatology, Avera Medical Group Dermatology Aberdeen, Aberdeen, South Dakota
| | - Yan Zhao
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Jia Liu
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Jiayi Yang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Yun Wu
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Ting Lv
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Ziyu Wei
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai, Jiaotong University, Shanghai, China
| | - Xiaojing Liu
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China
| | - Ruiping Wang
- Clinical Research Center, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Harrison Wong
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
| | - Qiang Ju
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai, Jiaotong University, Shanghai, China.
| | - Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China.
| | - Xiuli Wang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Institute of Photomedicine, Tongji University School of Medicine, Shanghai, China.
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16
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Soto‐Moreno A, Montero‐Vilchez T, Diaz‐Calvillo P, Molina‐Leyva A, Arias‐Santiago S. The impact of photodynamic therapy on skin homeostasis in patients with actinic keratosis: A prospective observational study. Skin Res Technol 2023; 29:e13493. [PMID: 38017667 PMCID: PMC10684974 DOI: 10.1111/srt.13493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AKs), but there is little information on how PDT affects skin barrier function. The objectives of this study are: To compare skin barrier function between skin with AKs and healthy skin and to evaluate the impact of PDT on skin homeostasis in patients with AKs. METHODS A prospective observational study was conducted in patients with AKs to evaluate epidermal barrier function and skin homeostasis before and 1 ek after receiving PDT. RESULTS A total of 21 subjects were included in the study, male/female ratio was 17:4, mean age was 75.86 years. The number of AKS observed before starting treatment was reduced with respect to those diagnosed 1 month after starting PDT (14.83 vs. 1.91, p < 0.0001). Application of PDT for treating AKs modifies epidermal barrier function. Immediately after the first session temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total antioxidant capacity (TAC) increased while pH decreased on lesional skin. After 1-month follow-up, the only remained change was the increased in SCH. Higher increases in temperature were observed when using occlusive PDT compared to mixed modality. 5-ALA and M-ALA seem to have a similar impact on skin barrier. CONCLUSIONS PDT can improve skin barrier function in patients with AKs. Skin homeostasis parameters can be used to assess efficacy and optimize dosing.
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Affiliation(s)
- Alberto Soto‐Moreno
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Trinidad Montero‐Vilchez
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Pablo Diaz‐Calvillo
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Alejandro Molina‐Leyva
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Salvador Arias‐Santiago
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
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Abstract
Light is an efficient technique that has a significant influence on contemporary medicine. Photodynamic therapy (PDT), which involves the combined action of photosensitizers (PSs), oxygen, and light, has emerged as a therapeutically promising method for treating a broad variety of solid tumors and infectious diseases. Photodynamic therapy is minimally invasive, has few side effects, lightens scars, and reduces tissue loss while preserving organ structure and function. In particular, PDT has a high healing potential for wounds (PDT stimulates wound healing by enhancing re-epithelialization, promoting angiogenesis as well as modulating skin homeostasis). Wound healing involves interactions between many different processes, including coagulation, inflammation, angiogenesis, cellular migration, and proliferation. Poor wound healing with diabetes or extensive burns remains a difficult challenge. This review emphasizes PDT as a potential research field and summarizes PDT's role in wound healing, including normal wounds, chronic wounds, and aging wounds.
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Affiliation(s)
- Hongqing Zhao
- Nanbu County People's Hospital, Nanchong City, Sichuan Province 637300, China
- Department of Dermatology, Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing 100048, China
- Jinzhou Medical University, No. 40 Songpo Road, Taihe District, Jinzhou City, Liaoning Province 121001, China
| | - Jiachen Sun
- Department of Dermatology, Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing 100048, China
| | - Yuguang Yang
- Department of Dermatology, Fourth Medical Center of Chinese PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing 100048, China
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Bhatia N. The Interventions to Minimize Pain During Photodynamic Therapy With 5-Aminolevulinic Acid for the Treatment of Cutaneous Diseases. J Drugs Dermatol 2023; 22:1082-1087. [PMID: 37943263 DOI: 10.36849/jdd.7637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Photosensitization with 5-aminolevulinic acid (ALA) combined with photodynamic therapy (PDT) is approved in the United States for the treatment of actinic keratosis (AK) and is used off-label for other indications including acne treatment and photo rejuvenation. However, pain, particularly during the initial illumination period, limits the utility of this highly efficacious therapy. Although modifications to conventional ALA-PDT protocols that improve tolerability without diminishing efficacy have been identified, few have been evaluated in randomized, controlled trials, and the number of variables involved in ALA incubation (eg, duration, occlusion, ALA formulation, and strength) and PDT illumination (eg, light source, fluence rate, irradiance, and duration) confounds standardization. Perhaps the most promising modifications to date involve continuous activation of low levels of protoporphyrin IX, the photoactive metabolite of ALA, as well as using shorter incubation times (with or without prolongation of illumination), lower irradiance, and daylight or combined (daylight and conventional) PDT. However, reimbursement of PDT with alternative light sources in the US is hampered by the US Food and Drug Administration (FDA) labeling, which specifies the blue or red light devices approved for use with corresponding marketed ALA 20% solution and 10% gel, respectively. This review summarizes the existing evidence with respect to pain control in patients undergoing ALA-PDT, recommendations from clinical experience, and goals for future research. J Drugs Dermatol. 2023;22(11):1082-1087 doi:10.36849/JDD.7637.
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19
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Yang J, Liu X, Cao Y, Wang P, Zhang H, Chen Q, Yang Y, Zeng Q, Zhang L, Wang X. 5-Aminolevulinic acid photodynamic therapy versus minocycline for moderate-to-severe rosacea: A single-center, randomized, evaluator-blind controlled study. J Am Acad Dermatol 2023; 89:711-718. [PMID: 37356626 DOI: 10.1016/j.jaad.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) showed potential to treat rosacea according to recent studies; however, a lack of clinical evidence and unclear adverse effects limit its use. OBJECTIVE To compare the effect of ALA-PDT vs minocycline on rosacea. METHODS In this single-center, randomized, evaluator-blind, controlled study, patients with moderate-to-severe rosacea were allocated to receive 3 to 5 sessions of ALA-PDT or 8 weeks of 100 mg daily minocycline treatment, followed by a 24-week follow-up. RESULTS Of all the 44 randomized patients, 41 received complete treatment (ALA-PDT: 20 and minocycline: 21 patients). At the end of treatment, ALA-PDT showed noninferior improvement of papulopustular lesions and Rosacea-specific Quality of Life compared with minocycline (median reduction of lesion count: 19 vs 22, median change of Rosacea-specific Quality of Life score: 0.48 vs 0.53). The Clinician's Erythema Assessment success of ALA-PDT was lower than that of minocycline's (35% vs 67%). Demodex density and relapse rate were comparable in both groups. Erythema, mild pain, and exudation were the most common adverse reactions of ALA-PDT. LIMITATIONS Limited sample size restricted us from drawing further conclusions. CONCLUSION As minocycline does, ALA-PDT can improve rosacea mainly in papulopustular lesions and patients' quality of life, indicating a new option for rosacea.
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Affiliation(s)
- Jin Yang
- 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
| | - 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
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qi Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yutong Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qingyu Zeng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Linglin Zhang
- 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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Kassem R, Barzilai A, Pras E, Sizopoulou C, Pavlotsky F. Bath psoralen plus ultraviolet-A photochemotherapy for chronic graft-versus-host disease: a retrospective cohort study. Int J Dermatol 2023; 62:1261-1265. [PMID: 37568259 DOI: 10.1111/ijd.16806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/20/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Chronic graft-versus-host disease is a severe complication of allogeneic stem cell and bone marrow transplantation. First-line immunosuppressive agents, such as steroids, are used to prevent this disease; however, they have multiple side effects. Therefore, bath psoralen plus ultraviolet-A (PUVA) is an alternative second-line treatment. This study aimed to evaluate the clinical efficacy of bath PUVA for managing chronic graft-versus-host disease. METHODS This retrospective, case-control study included 14 patients with extensive cutaneous chronic graft-versus-host disease, resistant to systemic corticosteroid, treated with bath PUVA. Major and partial responses were defined as clinical improvements of >70% and 50-70%, respectively. We analyzed the graft-versus-host disease clinical presentation and timing after allogeneic stem cell and bone marrow transplantation, bath PUVA doses, background diseases, additional treatments, and adverse effects. RESULTS We observed eight major (three lichenoid and five sclerodermatoid) and six partial (three lichenoid and three sclerodermatoid) responses after a mean of 28 treatment sessions. After 6 to 25 months, four of the eight patients with sclerodermatoid lesions and all those with lichenoid lesions experienced relapse but responded to additional treatment cycles. CONCLUSIONS Bath PUVA is well-tolerated and effective for extensive cutaneous chronic graft-versus-host disease. It allows rapid tapering of adjuvant immunosuppressants; however, most patients require prolonged maintenance phototherapy.
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Affiliation(s)
- Riad Kassem
- Department of Dermatology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, 69978, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, 69978, Israel
- Dermatopathology Service, Institute of Pathology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
| | - Elon Pras
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, 69978, Israel
- Institute of Genetics, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
| | - Christina Sizopoulou
- Department of Dermatology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, 69978, Israel
| | - Felix Pavlotsky
- Department of Dermatology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, 69978, Israel
- Phototherapy Unit, Department of Dermatology, Sheba Medical Center, Tel HaShomer, Ramat Gan, 52621, Israel
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Nestor MS, Han H, Ceci FM, Lawson A, Gade A. Evaluating the safety and efficacy of aminolevulinic acid 20% topical solution activated by pulsed dye laser and blue light in the treatment of facial cutaneous squamous cell carcinoma in situ. J Cosmet Dermatol 2023; 22:2471-2475. [PMID: 37365973 DOI: 10.1111/jocd.15886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) is the second most common cutaneous malignancy, after basal cell carcinoma (BCC). Photodynamic therapy (PDT) involves converting a photosensitizer to reactive oxygen intermediates, which preferentially bind to hyperproliferative tissue. The most commonly used photosensitizers are methyl aminolevulinate and aminolevulinic acid (ALA). Presently, ALA-PDT is approved in the US and Canada for the treatment of actinic keratoses on the face, scalp, and upper extremities. AIMS This cohort study evaluated the safety, tolerability, and efficacy of aminolevulinic acid, pulsed dye laser, and photodynamic therapy (ALA-PDL-PDT) for treatment of facial cutaneous squamous cell carcinoma in situ (isSCC). METHODS Twenty adult patients with biopsy-confirmed isSCC on the face were recruited. Only lesions 0.4-1.3 cm in diameter were included. Patients underwent two treatments with ALA-PDL-PDT spaced 30 days apart. The isSCC lesion was then excised 4-6 weeks following the second treatment for histopathological assessment. RESULTS No residual isSCC was detected in 17/20 (85%) patients. Two of the patients with residual isSCC had skip lesions present that explained the treatment failure. Excluding the patients with skip lesions, the posttreatment histological clearance rate was 17/18 (94%). Minimal side effects were reported. LIMITATIONS Our study was limited by small sample size and lack of long-term recurrence data. CONCLUSIONS The ALA-PDL-PDT protocol is a safe and well-tolerated treatment option for isSCC on the face, providing excellent cosmetic and functional results.
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Affiliation(s)
- Mark S Nestor
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Haowei Han
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Francesca M Ceci
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Alec Lawson
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Anita Gade
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
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22
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Zhang S, Wang X, Chen H, Cao H, Zhang H, Yang M, Zhu Y, Qin Q, Liu X, Wang J, Zhang G. Clinical efficacy and safety of two different hematoporphyrin monomethyl ether-mediated photodynamic therapy regimen in Chinese children with port-wine stain. Exp Dermatol 2023; 32:1371-1382. [PMID: 37157235 DOI: 10.1111/exd.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/27/2023] [Accepted: 04/30/2023] [Indexed: 05/10/2023]
Abstract
Hematoporphyrin monomethyl ether-photodynamic therapy (HMME-PDT) has achieved encouraging clinical outcomes in adult port-wine stain (PWS). Optimal treatment option for children with PWS was minimal. To compare whether the clinical effectiveness of HMME-PDT with the 5-min (fast) administration treatment regimen (FATR) was better than the 20-min (slow) administration treatment regimen (SATR) for PWS of children in vivo and in vitro. Thirty-four children with PWS were divided into two groups including FATR and SATR. The two groups received three times HMME-PDT, respectively. Treatment efficacy and safety were evaluated in vivo and in vitro. Erythema index (EI) was used to evaluate the clinical outcomes. Both FATR and SATR were effective and safe in children with PWS after HMME-PDT. There were significance differences between the two groups in reductions of EI after the second treatment (p < 0.001) and the third treatment (p < 0.001) with HMME-PDT. The serum HMME concentration reach the peak level at short time compare with SATR group. A significance increased superoxide levels were observed in FATR group compare to SATR groups in vitro (p < 0.05). Our study suggested that HMME-PDT was effective and safe for children with PWS, the therapy regimen with FATR was better in clinical efficacy than that of the SATR.
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Affiliation(s)
- Sheng Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Xiuwei Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Translational Medicine Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Huina Cao
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Hongli Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Ming Yang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Yun Zhu
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Qin Qin
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Xiaoyan Liu
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Jianhua Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Translational Medicine Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Gaolei Zhang
- Department of Dermatology and Venereology, Capital Institute of Pediatrics, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
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Pauleikhoff L, Rothaus K, Groß-Bölting F, Böhringer D, Lübke J, Agostini H, Lange C. [Photodynamic therapy in Germany-Quo vadis?]. Ophthalmologie 2023; 120:818-824. [PMID: 36884066 DOI: 10.1007/s00347-023-01825-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/11/2022] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) was originally approved for the treatment of neovascular age-related macular degeneration (nAMD) and secondary choroidal neovascularization in myopia (mCNV). In addition, it is used as an off-label treatment in patients with choroidal hemangioma, polypoidal choroidal vasculopathy (PCV), and central serous chorioretinopathy (CSC). OBJECTIVE To track the development of PDT treatment numbers in Germany between 2006 and 2021 and to investigate the composition of the therapeutic indications. METHODS In this retrospective study the quality reports of German hospitals were evaluated in the period from 2006 to 2019 and the number of PDTs performed was recorded. In addition, the range of indications for PDT was determined exemplarily for the Eye Center at Medical Center, University of Freiburg and the Eye Center at St. Franziskus Hospital in Münster between 2006 and 2021. Finally, the estimated prevalence of CSC and an estimate of cases requiring treatment were used to calculate the number of patients in need of PDT treatment in Germany. RESULTS The number of PDTs performed in Germany decreased from 1072 in 2006 to 202 in 2019. While PDT was used in 86% of cases in patients with nAMD and in 7% of cases with mCNV in 2006, it was mainly performed in patients with CSC (70%) and choroidal hemangiomas (21%) from 2016 to 2021. With an estimated incidence of CSC of 1:10,000 and assuming that 16% of patients develop chronic CCS requiring treatment, approximately 1330 PDTs would need to be performed per year in Germany for patients with newly diagnosed chronic CSC alone. CONCLUSION The decreasing numbers of PDT treatment performed in Germany is mainly due to a change to intravitreal injections as the preferred treatment for nAMD and mCNV. As PDT is currently the recommended treatment of choice for chronic CSC, an underprovision of PDT in Germany can be assumed. To enable an appropriate treatment for patients, a reliable verteporfin production, a simplified approval process by health insurance companies and a close cooperation between ophthalmologists in private practice and larger centers are urgently needed.
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Affiliation(s)
- L Pauleikhoff
- Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - K Rothaus
- Augenzentrum am St. Franzikus Hospital, Münster, Hohenzollernring 74, 48145, Münster, Deutschland
| | - F Groß-Bölting
- Augenzentrum am St. Franzikus Hospital, Münster, Hohenzollernring 74, 48145, Münster, Deutschland
| | - D Böhringer
- Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Lübke
- Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - H Agostini
- Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - C Lange
- Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland.
- Augenzentrum am St. Franzikus Hospital, Münster, Hohenzollernring 74, 48145, Münster, Deutschland.
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Min Z, Jing L, Jun Z, Simeng Q, Zhaoyang W, Zhao W, Weihui Z. Influential Factors in the Efficacy of Hemoporfin-Mediated Photodynamic Therapy for Port-wine Stains. Lasers Med Sci 2023; 38:162. [PMID: 37460668 DOI: 10.1007/s10103-023-03822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023]
Abstract
Hemoporfin-mediated photodynamic therapy (HMME-PDT) is commonly used in the treatment of port-wine stains (PWS). However, the influential factors for the efficacy of the treatment are not well defined. This study intends to observe the influential factors for the efficacy of HMME-PDT in the treatment of port-wine stains (PWS). A total of 551 patients with PWS of head and neck was enrolled in this retrospective study. Further screening the patients of facial PWS, 484 patients were chosen. Patients were treated with HMME-PDT. All patients received 1~3 sessions of treatment with 2~3-month intervals. We photographed the lesions before each session and 2~3 months after the last session. Ages, sessions, lesion subtypes, and previous treatment history were related to the response of HMME-PDT (P =0.032, P<0.001, P=0.012, P=0.003 respectively). Treatment sessions were the independent factor correlated with efficacy after 3 sessions of treatment. Patients with no treatment history targeting PWS showed higher efficacy than those were treated with laser or other photodynamic treatment (P<0.05). The efficacy was higher by increasing the sessions of treatment. The efficacy was higher for lesion on maxillary prominence area and mandibular prominence area that on frontonasal prominence area and optic vesicle area (P<0.05). HMME-PDT is an effective in the treatment of PWS. Patients received no previous treatment for PWS, total treatment sessions and lesion on maxillary prominence area and mandibular prominence area are positive factors.
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Affiliation(s)
- Zhu Min
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Liu Jing
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Zhou Jun
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Qiao Simeng
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Wang Zhaoyang
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Wang Zhao
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Zeng Weihui
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China.
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Hu C, Luo X, Jiang C, Lei S, Sun Y. Efficacy and Safety of Photodynamic Therapy for the Treatment of Actinic Keratoses: A Meta-Analysis Update of Randomized Controlled Trials. Dermatol Surg 2023; 49:544-551. [PMID: 37134239 DOI: 10.1097/dss.0000000000003784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Actinic keratoses (AKs) are common and some may evolve into squamous cell carcinoma. Photodynamic therapy (PDT), imiquimod, cryotherapy, and other methods have been reported to have good effects. However, which treatment is the most effective with the best cosmetic results and fewest complications is uncertain. OBJECTIVE To evaluate which method has the best efficacy and cosmetic results with less adverse events and recurrence rate. MATERIALS AND METHODS All relevant articles up to July 31, 2022 were searched from Cochrane, Embase, and PubMed databases. Extract and analyze the data of efficacy, cosmetic results, local reactions, and adverse effects. RESULTS Twenty-nine articles with 3,,850 participants and 24,747 lesions were included. Quality of evidence was generally high. The efficacy of PDT was better in complete response (CR) (lesions CR; risk ratio (RR) 1.87; 95% confidence interval (CI) 1.55-1.87/patient CR; RR 3.07; 95% CI 2.07-4.56), overall preference, and cosmetic results. The time cumulative meta-analysis showed that the curative effect was gradually increasing before 2004, and then gradually stabilizing. Two groups showed no statistically significant differences in recurrence. CONCLUSION Compared with other methods, PDT is significantly more effective for AK with excellent cosmetic results and reversible adverse effects.
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Affiliation(s)
- Chengjun Hu
- All authors are affiliated with the Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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Lultschik S, Tran J, Sapra S, Sharma K, Dong K. Non-Invasive Treatment of Basal Cell Carcinoma: Photodynamic Therapy Following Curettage. J Drugs Dermatol 2023; 22:481-485. [PMID: 37133481 DOI: 10.36849/jdd.7133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND To investigate the effectiveness, safety, patient satisfaction, and cosmetic outcome of Methyl Aminolevulinate-Photodynamic Therapy (MAL-PDT) following curettage in order to make recommendations for its use in dermatology practices. METHODS A retrospective chart review of patients who received MAL-PDT following curettage for the indication of basal cell carcinoma (BCC) between 2009 and 2016 at a single private clinic in Ontario, Canada. Two hundred and seventy-eight patients with 352 BCC lesions were included, consisting of 44.2% males (n=123) and 55.8% females (n=155) with a mean age of 57.24 years. The primary outcome measurement consisted of the cure rate. Secondary outcome measurements included side effects, patient satisfaction, and cosmetic outcome, as reported in the medical charts. RESULTS The overall cure rate was 90.3% (n=318). After controlling for age, sex, and lesion type, nasal lesions were approximately 2.82 (95% CI: 1.24-6.40, P=0.01) times more likely to experience a recurrence. 18.3% of patients (n=51) reported side effects, the most common being burning (n=19). Of those who expressed satisfaction, 100% (n=25) reported being happy. Of lesions with cosmetic data, 90.3% displayed a good response (n=149). CONCLUSION MAL-PDT following curettage is an effective and safe treatment option for BCC lesions with a good cosmetic outcome and suggested high patient satisfaction. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.7133.
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Bansal S, Bechara RI, Patel JD, Mehta HJ, Ferguson JS, Witt BL, Murgu SD, Yasufuku K, Casal RF. Safety and Feasibility of Photodynamic Therapy for Ablation of Peripheral Lung Tumors. J Bronchology Interv Pulmonol 2023; 30:135-143. [PMID: 35968968 PMCID: PMC10063184 DOI: 10.1097/lbr.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Newer navigational bronchoscopy technologies render peripheral lung lesions accessible for biopsy and potential treatment. We investigated whether photodynamic therapy (PDT) delivered via navigational bronchoscopy is feasible and safe for ablation of peripheral lung tumors. METHODS Two studies evaluated PDT in patients with solid peripheral lung tumors followed by clinical follow-up (nonresection study, N=5) or lobectomy (resection study, N=10). Porfimer sodium injection was administered 40 to 50 hours before navigational bronchoscopy. Lesion location was confirmed by radial probe endobronchial ultrasonography. An optical fiber diffuser was placed within or adjacent to the tumor under fluoroscopic guidance; laser light (630 nm wavelength) was applied at 200 J/cm of diffuser length for 500 seconds. Tumor response was assessed by modified Response Evaluation Criteria in Solid Tumors at 3 and 6 months postprocedure (nonresection study) and pathologically (resection study). RESULTS There were no deaths, discontinuations for adverse events, or serious or grade ≥3 adverse events related to study treatments. Photosensitivity reactions occurred in 8 of 15 patients: 6 mild, 1 moderate, 1 severe (elevated porphyrins noted in blood after treatment). Among 5 patients with clinical follow-up, 1 had complete response, 3 had stable disease, and 1 had progressive disease at 6 months follow-up. Among 10 patients who underwent lobectomy, 1 had no evidence of tumor at resection (complete response), 3 had 40% to 50% tumor cell necrosis, 2 had 20% to 35%, and 4 had 5% to 10%. CONCLUSION PDT for nonthermal ablation of peripheral lung tumors was feasible and safe in this small study. Further study is warranted to evaluate efficacy and corroborate the safety profile.
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Affiliation(s)
- Sandeep Bansal
- Interventional Pulmonology, The Lung Center, Penn Highlands Healthcare, DuBois, PA
| | - Rabih I. Bechara
- Interventional Pulmonology, Medical College of Georgia School of Medicine, Augusta University, Augusta, GA
| | - Jiten D. Patel
- Pulmonary Medicine, Providence Sacred Heart Medical Center and Children’s Hospital, Spokane, WA
| | - Hiren J. Mehta
- Interventional Pulmonology, University of Florida, Gainesville, FL
| | - J. Scott Ferguson
- Interventional Pulmonology, School of Medicine and Public Health and the Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Benjamin L. Witt
- Association of Regional Utah Pathologists (ARUP) Laboratories, University of Utah, Salt Lake City, UT
| | - Septimiu D. Murgu
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Roberto F. Casal
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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Arcuri D, Ramchatesingh B, Lagacé F, Iannattone L, Netchiporouk E, Lefrançois P, Litvinov IV. Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review. Int J Mol Sci 2023; 24:ijms24054989. [PMID: 36902419 PMCID: PMC10003023 DOI: 10.3390/ijms24054989] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
Actinic keratosis (AK) is among the most commonly diagnosed skin diseases with potentially life-threatening repercussions if left untreated. Usage of pharmacologic agents represents one of many therapeutic strategies that can be used to help manage these lesions. Ongoing research into these compounds continues to change our clinical understanding as to which agents most benefit particular patient populations. Indeed, factors such as past personal medical history, lesion location and tolerability of therapy only represent a few considerations that clinicians must account for when prescribing appropriate treatment. This review focuses on specific drugs used in either the prevention or treatment of AKs. Nicotinamide, acitretin and topical 5-fluorouracil (5-FU) continue to be used with fidelity in the chemoprevention of actinic keratosis, although some uncertainty persists in regard to which agents should be used in immunocompetent vs. immunodeficient/immunosuppressed patients. Topical 5-FU, including combination formulations with either calcipotriol or salicylic acid, as well as imiquimod, diclofenac and photodynamic light therapy are all accepted treatment strategies employed to target and eliminate AKs. Five percent of 5-FU is regarded as the most effective therapy in the condition, although the literature has conflictingly shown that lower concentrations of the drug might also be as effective. Topical diclofenac (3%) appears to be less efficacious than 5% 5-FU, 3.75-5% imiquimod and photodynamic light therapy despite its favorable side effect profile. Finally, traditional photodynamic light therapy, while painful, appears to be of higher efficacy in comparison to its more tolerable counterpart, daylight phototherapy.
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Affiliation(s)
- Domenico Arcuri
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
| | | | - François Lagacé
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
| | - Lisa Iannattone
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
| | | | | | - Ivan V. Litvinov
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
- Division of Dermatology, McGill University Health Center, Montreal, QC H4A 3J1, Canada
- Correspondence:
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Guo Y, Zeng M, Yuan Y, Yuan M, Chen Y, Yu H, Liu R, Ruan Z, Xie Q, Jiao X, Lu T. Photodynamic therapy treats acne by altering the composition of the skin microbiota. Skin Res Technol 2023; 29:e13269. [PMID: 36704881 PMCID: PMC9838775 DOI: 10.1111/srt.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Acne is the eighth-most prevalent inflammatory skin disease with no optimal treatment. Photodynamic therapy (PDT) is an effective treatment for severe acne. AIMS The effect of PDT on the composition and diversity of skin microflora in severe acne patients was studied. MATERIALS AND METHODS A total of 18 patients with severe acne and 8 healthy individuals were selected for this study. Patients were treated with 5-aminolevulinic acid-mediated PDT once a week three times in total; the skin microbiome was measured by 16S ribosomal RNA gene sequencing before and after treatment (1 week after each PDT). RESULTS The microflora composition was different between healthy controls and patients, and between patients before and after treatment. Alpha diversity indices were lower in patients than those in control. There were 15 bacterial genera with high relative abundance that had noticeable changes during treatment. At the genus level,particularly Cutibacterium acnes (C. acnes formerly Propionibacterium acnes), there was no statistically significant difference among different group. The abundances of Staphylococcus epidermidis and Staphylococcus aureus were low. DISCUSSION The microbial composition is different between severe acne patients acne patients and healthy individuals. The therapeutic efficacy of severe acne treated with PDT is associated with the composition and diversity of skin microbiota. CONCLUSION The skin microbial composition changes after PDT treatment. PDT is an effective method for the treatment of severe acne.
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Affiliation(s)
- Yangmin Guo
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
- Department of DermatologyHuizhou Dermatology HospitalHuizhouChina
| | - Mi Zeng
- Department of Cell Biology and GeneticsShantou University Medical CollegeShantouChina
| | - Yumeng Yuan
- Department of Cell Biology and GeneticsShantou University Medical CollegeShantouChina
| | - Mengsi Yuan
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Yanxia Chen
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Haoyang Yu
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Ruimin Liu
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zhijie Ruan
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Qingdong Xie
- Department of Cell Biology and GeneticsShantou University Medical CollegeShantouChina
| | - Xiaoyang Jiao
- Department of Cell Biology and GeneticsShantou University Medical CollegeShantouChina
| | - Tao Lu
- Department of DermatologyFirst Affiliated Hospital of Shantou University Medical CollegeShantouChina
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Bao N, Gu T, Zeng J, Wu Y, Sun Y, Gao X, Chen H. Combined therapy of 5-aminolevulinic acid photodynamic therapy and intense pulsed light for rosacea. Lasers Med Sci 2022; 38:17. [PMID: 36562857 DOI: 10.1007/s10103-022-03685-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/19/2022] [Indexed: 12/24/2022]
Abstract
Rosacea is difficult to treat. Therefore, new alternative modalities are necessary to demonstrate. The present study was conducted to assess the efficacy and safety of the combined therapy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and intense pulsed light (IPL) for rosacea to provide a new treatment option for rosacea. The study was conducted from November 2017 to April 2019 at the Department of Dermatology, The First Hospital of China Medical University. Patients aged 18-65 years and diagnosed clinically as erythematotelangiectatic (ET) or papulopustular (PP) rosacea were enrolled. Three times of ALA-PDT at 10 days interval followed by 3 times of IPL at 3-4 weeks interval were defined as 1 session and applied to the whole face of each patient. ALA-PDT: 5% ALA, red light (fluency dose 60-100 mW/cm2, 20 min); IPL: 560/590/640 nm, double/triple-pulse mode, pulse width 3.0 to 4.5 ms, delay time 30-40 ms, energy fluency 14-17 J/cm2. Ten patients were enrolled in the study. Among them, 4 patients received only 1 session, while 6 patients received 2 sessions. After all treatments, 50% of patients achieved 75-100% improvement, and 30% achieved 50-75% improvement. Forty percent of patients were graded very satisfaction and 30% graded moderate satisfaction. All noninvasive measurements showed no significant differences among all time points (p > 0.05). The side effects were pain, burning sensation, itching, erythema, desquamation, slight edema, slight exudation, and hyperpigmentation. All of which were tolerable and recovered in a few days. The combined therapy of ALA-PDT and IPL showed an effective option for rosacea with a safety profile.
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Affiliation(s)
- NaiJia Bao
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China
- Ultrasonic ECG Center, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - TianShu Gu
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China
| | - Jing Zeng
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, China
| | - Yan Wu
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China.
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, China.
| | - Yan Sun
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China.
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, China.
| | - XingHua Gao
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, China
| | - HongDuo Chen
- Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, China
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Gobeka HH, Mentes J, Nalcaci S, Oztas Z, Cay Y. Morphological integrity of the outer retinal layers and visual prognosis in chronic central serous chorioretinopathy after half-dose photodynamic therapy: a qualitative SD-OCT analysis. Lasers Med Sci 2022; 38:9. [PMID: 36539551 DOI: 10.1007/s10103-022-03676-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022]
Abstract
The study aims to investigate the morphological integrity of the outer retinal layers (ORLs) (an ellipsoid layer (EL) + external limiting membrane) and visual prognosis in chronic central serous chorioretinopathy (CSCR) with subretinal fluid (SRF) completely resorbed after half-dose photodynamic therapy (HD PDT) using enhanced-depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT). This retrospective study included 40 eyes of 38 chronic CSCR patients treated with HD PDT between December 2012 and June 2016. However, only 34 eyes (85%) with complete SRF resorption 3 months after HD PDT had their 6th and 12th month data analyzed. Morphological integrity of the ORLs was further analyzed in relation to best-corrected visual acuity (BCVA) and disease duration. Thirty-four eyes of 34 patients (male/female: 82.35/17.65%) with mean age of 49.90 ± 7.80 (32-61) years were studied. The mean logMAR BCVA improved significantly from 0.52 ± 0.31 at baseline to 0.34 ± 0.36 and 0.26 ± 0.26 at the 6th and 12th months after HD PDT, respectively (p < 0.001). The proportion of eyes with completely normal morphological ultrastructural integrity of the ORLs was 44.12% at the 6th month, which increased to 64.71% at the 12th month after HD PDT. However, the EL morphological disruption was associated with significantly lower mean logMAR BCVA 12 months after HD PDT (p = 0.029). The disease duration had no effect on mean logMAR BCVA gain. Even after complete resorption of serous neurosensory retinal detachment after HD PDT in chronic CSCR, the ORLs, especially the EL, may not be anatomically restored. The EL morphological ultrastructural integrity seems to be the most important factor influencing visual prognosis.
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Affiliation(s)
- Hamidu Hamisi Gobeka
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
- Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Jale Mentes
- Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Serhad Nalcaci
- Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Zafer Oztas
- Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yigit Cay
- Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir, Turkey
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Kim EJ, Mangold AR, DeSimone JA, Wong HK, Seminario-Vidal L, Guitart J, Appel J, Geskin L, Lain E, Korman NJ, Zeitouni N, Nikbakht N, Dawes K, Akilov O, Carter J, Shinohara M, Kuzel TM, Piette W, Bhatia N, Musiek A, Pariser D, Kim YH, Elston D, Boh E, Duvic M, Huen A, Pacheco T, Zwerner JP, Lee ST, Girardi M, Querfeld C, Bohjanen K, Olsen E, Wood GS, Rumage A, Donini O, Haulenbeek A, Schaber CJ, Straube R, Pullion C, Rook AH, Poligone B. Efficacy and Safety of Topical Hypericin Photodynamic Therapy for Early-Stage Cutaneous T-Cell Lymphoma (Mycosis Fungoides): The FLASH Phase 3 Randomized Clinical Trial. JAMA Dermatol 2022; 158:1031-1039. [PMID: 35857290 PMCID: PMC9301595 DOI: 10.1001/jamadermatol.2022.2749] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Given that mycosis fungoides-cutaneous T-cell lymphoma (MF/CTCL) is chronic, there is a need for additional therapies with minimal short- and long-term adverse effects. Topical synthetic hypericin ointment, 0.25%, activated with visible light is a novel, nonmutagenic photodynamic therapy (PDT). Objectives To determine the efficacy and safety of topical synthetic hypericin ointment, 0.25%, activated with visible light as a nonmutagenic PDT in early-stage MF/CTCL. Design, Settings, and Participants This was a multicenter, placebo-controlled, double-blinded, phase 3 randomized clinical trial (FLASH study) conducted from December 2015 to November 2020 at 39 academic and community-based US medical centers. Participants were adults (≥18 years) with early-stage (IA-IIA) MF/CTCL. Interventions In cycle 1, patients were randomized 2:1 to receive hypericin or placebo to 3 index lesions twice weekly for 6 weeks. In cycle 2, all patients received the active drug for 6 weeks to index lesions. In cycle 3 (optional), both index and additional lesions received active drug for 6 weeks. Main Outcomes and Measures The primary end point was index lesion response rate (ILRR), defined as 50% or greater improvement in modified Composite Assessment of Index Lesion Severity (mCAILS) score from baseline after 6 weeks of therapy for cycle 1. For cycles 2 and 3, open label response rates were secondary end points. Adverse events (AEs) were assessed at each treatment visit, after each cycle, and then monthly for 6 months. Data analyses were performed on December 21, 2020. Results The study population comprised 169 patients (mean [SD] age, 58.4 [16.0] years; 96 [57.8%] men; 120 [72.3%] White individuals) with early-stage MF/CTCL. After 6 weeks of treatment, hypericin PDT was more effective than placebo (cycle 1 ILRR, 16% vs 4%; P = .04). The ILRR increased to 40% in patients who received 2 cycles of hypericin PDT (P < .001 vs cycle 1 hypericin) and to 49% after 3 cycles (P < .001 vs cycle 1 hypericin). Significant clinical responses were observed in both patch and plaque type lesions and were similar regardless of age, sex, race, stage IA vs IB, time since diagnosis, and number of prior therapies. The most common treatment-related AEs were mild local skin (13.5%-17.3% across cycles 1-3 vs 10.5% for placebo in cycle 1) and application-site reactions (3.2%-6.9% across cycles 1-3 vs 4% for placebo in cycle 1). No drug-related serious AEs occurred. Conclusion and Relevance The findings of this randomized clinical trial indicate that synthetic hypericin PDT is effective in early-stage patch and plaque MF/CTCL and has a favorable safety profile. Trial Registration ClinicalTrials.gov Identifier: NCT02448381.
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Affiliation(s)
- Ellen J. Kim
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | | | - Henry K. Wong
- University of Arkansas for Medical Sciences, Little Rock
| | | | - Joan Guitart
- Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - James Appel
- PMG Research of Wilmington, Wilmington, North Carolina
- Campbell University−Sampson Regional Medical Center, Buies Creek, North Carolina
| | - Larisa Geskin
- Columbia University Medical Center, New York, New York
| | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, Texas
| | - Neil J. Korman
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kenneth Dawes
- Dawes Fretzin Dermatology Group, Indianapolis, Indiana
| | - Oleg Akilov
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Joi Carter
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Michi Shinohara
- University of Washington−Seattle Cancer Care Alliance, Seattle
| | | | | | - Neal Bhatia
- Therapeutics Clinical Research, San Diego, California
| | - Amy Musiek
- Washington University School of Medicine, St Louis, Missouri
| | | | - Youn H. Kim
- Stanford University School of Medicine, Stanford, California
| | - Dirk Elston
- Medical University of South Carolina, Charleston
| | - Erin Boh
- Tulane University, New Orleans, Louisiana
| | | | - Auris Huen
- University of Texas−MD Anderson Cancer Center, Houston
| | | | | | - Seung Tae Lee
- University of Maryland Comprehensive Cancer Center, Baltimore
| | | | | | | | - Elise Olsen
- Duke University Medical Center, Durham, North Carolina
| | | | | | | | | | | | | | | | - Alain H. Rook
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Brian Poligone
- Rochester Skin Lymphoma Medical Group, Fairport, New York
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Mishra K, Mahajan VB. Bacillary Layer Detachment after Photodynamic Therapy. Ophthalmol Retina 2022; 6:500. [PMID: 35680235 PMCID: PMC10593128 DOI: 10.1016/j.oret.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Kapil Mishra
- Molecular Surgery Program, Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Vinit B Mahajan
- Molecular Surgery Program, Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, Palo Alto, California
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Honda S, Kohno T, Yamamoto M, Hirayama K, Kyo A, Hirabayashi M, Honda S. Early anatomical changes and association with photodynamic therapy induced acute exudative maculopathy in patients with macular diseases. Sci Rep 2022; 12:9105. [PMID: 35650246 PMCID: PMC9160278 DOI: 10.1038/s41598-022-13208-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to investigate the occurrence rate and predictors of photodynamic therapy (PDT) induced acute exudative maculopathy (PAEM). This retrospective study included 39 eyes of 39 patients (32 males and 7 females), who were treated with initial PDT. PAEM was defined as an increase in central retinal thickness (CRT) of 15% or more measured by OCT on day 3 after PDT compared with baseline. Sixteen of 39 eyes (41%) were classified in the PAEM+ group. CRT and central choroidal thickness (CCT) were significantly increased at 3 days in the PAEM+ group and significantly decreased at 1 month after PDT in the PAEM- group. In a multiple comparison, neovascular age-related macular degeneration (nAMD) had a significantly higher incidence of PAEM compared to polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC). The incidence of PAEM was lower in PCV and CSC, and higher in nAMD. BCVA at 1 month was significantly worse in the PAEM group, which may be related to visual prognosis after PDT. Since both CRT and CCT decrease at 1 month, the detection of PAEM needs to be assessed a few days after PDT.
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Affiliation(s)
- Satoshi Honda
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Takeya Kohno
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Manabu Yamamoto
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan.
| | - Kumiko Hirayama
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Akika Kyo
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | | | - Shigeru Honda
- Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
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Lonsdorf AS, Keller A, Hartmann J, Enk AH, Gholam P. Ablative Fractional Laser-assisted Low-irradiance Photodynamic Therapy for Treatment of Actinic Keratoses in Organ Transplant Recipients: A Prospective, Randomized, Intraindividual Controlled Trial. Acta Derm Venereol 2022; 102:adv00694. [PMID: 35356991 PMCID: PMC9558342 DOI: 10.2340/actadv.v102.1057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pain and inferior efficacy are major limiting factors of conventional photodynamic therapy for the field treatment of actinic keratoses in immunosuppressed organ transplant recipients. This prospective randomized controlled study evaluates the efficacy and tolerability of ablative fractional laser system pretreatment combined with low-irradiance photodynamic therapy (18.5 mW/cm2) compared with conventional photodynamic therapy (61.67 mW/cm2) in the treatment of actinic keratoses on the face and scalp in organ transplant recipients, using a red light-emitting diode lamp at a total light dose of 37 J/cm2. Low-irradiance photodynamic therapy combined with Er:YAG pretreatment achieved a significantly superior lesion response rate (mean ± standard deviation 77.3 ± 23.6%) compared with conventional photodynamic therapy (61.8 ± 21.4%; p = 0.025) in intra-individual fields at 3 months without negatively impacting pain (p = 0.777) or cosmetic outcome (p = 0.157).
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Affiliation(s)
- Anke S Lonsdorf
- Department of Dermatology, University Hospital Heidelberg, Germany.
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Candela L, Kasraeian A, Barret E. Current evidence for focal laser ablation and vascular-targeted photodynamic therapy for localized prostate cancer: review of literature published in the last 2 years. Curr Opin Urol 2022; 32:192-198. [PMID: 35013079 DOI: 10.1097/mou.0000000000000964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Currently, a significant number of patients are diagnosed with unilateral and apparently unifocal low or intermediate-risk prostate cancer (PCa). These patients are suitable for focal therapy, thus preventing radical treatment side effects without affecting cancer control. Among focal therapy energy sources, laser-based technologies have shown promising outcomes. We aimed to summarize recent data on focal laser ablation (FLA) and vascular-targeted photodynamic therapy (VTP) for PCa. RECENT FINDINGS We selected eight studies reporting data on 1155 patients with PCa who underwent laser-based focal therapy. Five studies were on FLA and three on VTP (six prospective and two retrospective series); four reported both oncologic and functional outcomes whereas in three only oncologic and one only functional outcomes were discussed. Follow-up protocols and durations varied widely among the studies. PCa recurrence rates ranged between 20 and 56%. Urinary and erectile function were preserved after treatment, and complications were mild and transient. A lack of high-quality data on long-term oncological outcomes still remains, thus further highlighting the need for prospective controlled studies. SUMMARY FLA and VTP are well tolerated procedures with excellent functional outcomes. However, both procedures showed a significant rate of PCa recurrence, thus demonstrating a certain grade of oncologic control failure of the procedure and/or nonoptimal patients' selection.
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Affiliation(s)
- Luigi Candela
- Urology Department, Institut Mutualiste Montsouris, Paris, France
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Eric Barret
- Urology Department, Institut Mutualiste Montsouris, Paris, France
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Ishii H, Yoshida J, Toyono T, Yamagami S, Usui T, Miyai T. Three-year results of accelerated transepithelial cross-linking (30 mW/cm2 × 3 min) for keratoconus: a prospective study. BMJ Open Ophthalmol 2022; 7:e000827. [PMID: 35224204 PMCID: PMC8830257 DOI: 10.1136/bmjophth-2021-000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/21/2022] [Indexed: 11/04/2022] Open
Abstract
ObjectiveTo assess the long-term efficacy and safety of accelerated transepithelial corneal cross-linking (ATE-CXL) with 30 mW/cm2 × 3 min.Methods and AnalysisThirty-four eyes of 23 patients with progressive keratoconus (KCN) recruited within a single centre were enrolled in this prospective interventional study. Exclusion criteria included: history of Descemet’s membrane rupture, glaucoma, uveitis, severe dry eye, concurrent corneal infections, and systemic disease that could affect corneal healing. ATE-CXL was performed with 3 min of ultraviolet-A continuous irradiation (30 mW/cm2). Follow-up examinations were scheduled on postoperative day 1; 1 and 2 weeks; 1, 3 and 6 months; and 1, 2 and 3 years. Main outcome measures were maximum corneal power (Kmax), average corneal power (AvgK), steepest corneal power (Ks), central corneal thickness, thinnest corneal thickness, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA) and endothelial cell density.ResultsMean Kmax, AvgK, Ks, UCVA, BCVA and endothelial cell density did not significantly change over 3 years. The speed of progression obtained by linear regression analysis on corneal parameters (Kmax, AvgK, Ks) improved after ATE-CXL. All baseline parameters correlated with the postoperative Kmax slope. Two eyes underwent ATE-CXL redo because of continued progression after the primary CXL.ConclusionThis is the first report of 3-year results of ATE-CXL with 30 mW/cm2 × 3 min. ATE-CXL (30 mW/cm2 × 3 min) was safe and effective for slowing down KCN progression.Trial registration numberThis study was registered with ID UMIN000009372 in UMIN-Clinical Trials Registry.
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Affiliation(s)
- Hitoha Ishii
- The Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Junko Yoshida
- The Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
- Department of Ophthalmology, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Tetsuya Toyono
- The Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Satoru Yamagami
- Division of Ophthalmology, Department of Visual Sciences, Nihon Daigaku, Chiyoda-ku, Tokyo, Japan
| | - Tomohiko Usui
- Department of Ophthalmology, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Takashi Miyai
- The Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
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Trojan J, Hoffmeister A, Neu B, Kasper S, Dechêne A, Jürgensen C, Schirra J, Jakobs R, Palmer D, Selbo PK, Olivecrona H, Finnesand L, Høgset A, Walday P, Sturgess R. OUP accepted manuscript. Oncologist 2022; 27:430-e433. [PMID: 35675633 PMCID: PMC9177099 DOI: 10.1093/oncolo/oyab074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Background Photochemical internalization (PCI) is a novel technology for light-induced enhancement of the local therapeutic effect of cancer drugs, utilizing a specially designed photosensitizing molecule (fimaporfin). The photosensitizing molecules are trapped in endosomes along with macromolecules or drugs. Photoactivation of fimaporfin disrupts the endosomal membranes so that drug molecules are released from endosomes inside cells and can reach their therapeutic target in the cell cytosol or nucleus. Compared with photodynamic therapy, the main cytotoxic effect with PCI is disruption of the endosomal membrane resulting in delivery of chemotherapy drug, and not to the photochemical reactions per se. In this study we investigated the effect of PCI with gemcitabine in patients with inoperable perihilar cholangiocarcinoma (CCA). Methods The in vitro cytotoxic effect of PCI with gemcitabine was studied on two CCA-derived cell lines. In a fimaporfin dose-escalation phase I clinical study, we administered PCI with gemcitabine in patients with perihilar CCA (n = 16) to establish a safe and tolerable fimaporfin dose and to get early signals of efficacy. The patients enrolled in the study had tumors in which the whole length of the tumor could be illuminated from the inside of the bile duct, using an optical fiber inserted via an endoscope (Fig. 1). Fimaporfin was administered intravenously at day 0; gemcitabine (i.v.) and intraluminal biliary endoscopic laser light application on day 4; followed by standard gemcitabine/cisplatin chemotherapy. Results Preclinical experiments showed that PCI enhanced the effect of gemcitabine. In patients with CCA, PCI with gemcitabine was well tolerated with no dose-limiting toxicities, and no unexpected safety signals. Disease control was achieved in 10 of 11 evaluable patients, with a clearly superior effect in the two highest dose groups. The objective response rate (ORR) was 42%, including two complete responses, while ORR at the highest dose was 60%. Progression-free survival at 6 months was 75%, and median overall survival (mOS) was 15.4 months, with 22.8 months at the highest fimaporfin dose. Conclusion Photochemical internalization with gemcitabine was found to be safe and resulted in encouraging response and survival rates in patients with unresectable perihilar CCA.
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Affiliation(s)
- Jörg Trojan
- Corresponding author: Jörg Trojan, MD, University Hospital and Cancer Center Medical Department 1, Goethe University, Theodor-Stern-Kai 7, Frankfurt 60590, Germany. Tel: +49 69 6301 7860;
| | - Albrecht Hoffmeister
- Department of Medicine (Gastroenterology), University of Leipzig, Leipzig, Germany
| | - Bruno Neu
- Technical University, Munich, Germany (now at Krankenhaus Lanshut-Achdorf)
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer, University Hospital Essen, Essen, Germany
| | - Alexander Dechêne
- Department of Gastroenterology, Hepatology and Endocrinology, Klinikum Nuremberg, Paracelsus Medical University, Nuremburg, Germany
| | | | - Jörg Schirra
- Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Ralf Jakobs
- Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Dan Palmer
- University Hospital Aintree, Liverpool, UK
| | - Pål k. Selbo
- Oslo University Hospital--The Norwegian Radium Hospital, Oslo, Norway
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Saengsirinavin AO, Ma D, Stewart JM. TRANSIENT PARADOXICAL WORSENING OF VISION DUE TO GRAVITATIONAL SHIFT OF SUBRETINAL FLUID AFTER PHOTODYNAMIC THERAPY FOR CENTRAL SEROUS CHORIORETINOPATHY. Retin Cases Brief Rep 2021; 15:676-681. [PMID: 31313703 DOI: 10.1097/icb.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report an atypical treatment-related complication from photodynamic therapy in central serous chorioretinopathy patient and explain its mechanism. METHODS History, physical examination, and imaging data were retrospectively reviewed and obtained from the electronic medical records of the patient. RESULTS A central serous chorioretinopathy patient with several focal leakage spots near the superotemporal arcade was treated with half-fluence verteporfin photodynamic therapy. The patient complained of worse vision after the treatment. Examination showed relocation of subretinal fluid from the superior macula to the central and submacular area, explained by a gravitational shift of subretinal fluid and the predisposing factor of a previously weakened junction between the retinal pigment epithelium and neurosensory retina. Without further treatment, the fluid reabsorbed, and the patient's vision returned to normal. CONCLUSION This is the first report to describe this transient atypical adverse visual outcome early after photodynamic therapy in a central serous chorioretinopathy patient, caused by a gravitational shift of viscous subretinal fluid.
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Affiliation(s)
- Aim-On Saengsirinavin
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand ; and
| | - Dahui Ma
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen, China
| | - Jay M Stewart
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
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Treatment of onychomycosis. Med Lett Drugs Ther 2021; 63:164-8. [PMID: 35050243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Takahashi J, Nagasawa S, Doi M, Takahashi M, Narita Y, Yamamoto J, Ikemoto MJ, Iwahashi H. In Vivo Study of the Efficacy and Safety of 5-Aminolevulinic Radiodynamic Therapy for Glioblastoma Fractionated Radiotherapy. Int J Mol Sci 2021; 22:ijms22189762. [PMID: 34575921 PMCID: PMC8470662 DOI: 10.3390/ijms22189762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/20/2022] Open
Abstract
To treat malignant glioma, standard fractionated radiotherapy (RT; 60 Gy/30 fractions over 6 weeks) was performed post-surgery in combination with temozolomide to improve overall survival. Malignant glioblastoma recurrence rate is extremely high, and most recurrent tumors originate from the excision cavity in the high-dose irradiation region. In our previous study, protoporphyrin IX physicochemically enhanced reactive oxygen species generation by ionizing radiation and combined treatment with 5-aminolevulinic acid (5-ALA) and ionizing radiation, while radiodynamic therapy (RDT) improved tumor growth suppression in vivo in a melanoma mouse model. We examined the effect of 5-ALA RDT on the standard fractionated RT protocol using U251MG- or U87MG-bearing mice. 5-ALA was orally administered at 60 or 120 mg/kg, 4 h prior to irradiation. In both models, combined treatment with 5-ALA slowed tumor progression and promoted regression compared to treatment with ionizing radiation alone. The standard fractionated RT protocol of 60 Gy in 30 fractions with oral administration of 120 and 240 mg/kg 5-ALA, the human equivalent dose of photodynamic diagnosis, revealed no significant increase in toxicity to normal skin or brain tissue compared to ionizing radiation alone. Thus, RDT is expected to enhance RT treatment of glioblastoma without severe toxicity under clinically feasible conditions.
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Affiliation(s)
- Junko Takahashi
- Graduate School of Information, Production and Systems, Waseda University, Fukuoka 808-0135, Japan
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki 305-8566, Japan;
- Correspondence: ; Tel.: +81-936-92-5154
| | - Shinsuke Nagasawa
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
| | - Motomichi Doi
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki 305-8566, Japan;
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (M.T.); (Y.N.)
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (M.T.); (Y.N.)
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Fukuoka 807-8555, Japan;
| | - Mitsushi J. Ikemoto
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki 305-8566, Japan;
| | - Hitoshi Iwahashi
- The United Graduate School of Agricultural Science, Gifu University, Gifu 501-1193, Japan;
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Affiliation(s)
- Kristen Kay
- School of Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Paige Hoyer
- Department of Dermatology, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Vlad Codrea
- Department of Dermatology, University of West Virginia, Morgantown, West Virginia
| | - Aaron K Joseph
- Department of Dermatology, University of Texas Medical Branch at Galveston, Galveston, Texas
- US Dermatology Partners, Pasadena, Texas
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Madray VM, Kent SM, Davis LS. Aminolevulinic Acid Photodynamic Therapy-Induced Erosive Pustular Dermatosis of the Scalp. Dermatol Surg 2021; 47:1140-1142. [PMID: 33731561 DOI: 10.1097/dss.0000000000002988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- V M Madray
- Medical College of Georgia at Augusta University, Augusta, Georgia
| | - S M Kent
- Department of Dermatology at Augusta University, Augusta, Georgia
| | - L S Davis
- Department of Dermatology at Augusta University, Augusta, Georgia
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Grassmeyer JJ, Goertz JG, Baartman BJ. Diffuse Lamellar Keratitis in a Patient Undergoing Collagen Corneal Cross-Linking 18 Years After Laser In Situ Keratomileusis Surgery. Cornea 2021; 40:917-920. [PMID: 34086008 PMCID: PMC8178513 DOI: 10.1097/ico.0000000000002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/26/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a case of diffuse lamellar keratitis (DLK) after corneal collagen cross-linking in an eye with a remote history of laser in situ keratomileusis (LASIK) surgery. METHODS This is a case report and literature review. RESULTS This report describes the development of unilateral stage IV DLK in a patient who underwent bilateral corneal cross-linking for corneal ectasia 18 years after LASIK surgery. The patient was treated with high-dose topical steroids that were tapered over 1 month and multiple flap lifts. The ultimate best-corrected visual outcome was 20/60. CONCLUSIONS DLK is a potential sight-threatening complication of refractive surgery that can occur at any time in the postoperative period, even years after the procedure. Undergoing a subsequent corneal procedure that may disrupt or promote inflammation within the surgical flap-stromal interface, such as corneal collagen cross-linking, is a recognized risk factor for the development of DLK. This case suggests that patients with any history of LASIK surgery undergoing corneal cross-linking or other lamellar corneal surgeries may benefit from closer follow-up (eg, daily) than patients with no history of LASIK.
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Okhovat JP, Shumaker P, Lee KC. Comparison of the safety and efficacy of daylight photodynamic therapy and conventional photodynamic therapy for actinic keratoses: A systematic review demonstrating noninferiority. J Am Acad Dermatol 2021; 86:1444-1446. [PMID: 34214621 DOI: 10.1016/j.jaad.2021.05.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022]
Affiliation(s)
| | - Peter Shumaker
- VA San Diego Healthcare System and Department of Dermatology, University of California, San Diego, Californnia
| | - Kachiu C Lee
- Department of Dermatology, Temple University, Philadelphia, Pennsylvania.
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Abstract
Photodynamic therapy (PDT) has been considered a noninvasive and cost-effective modality for tumor treatment. However, the complexity of tumor microenvironments poses challenges to the implementation of traditional PDT. Here, we review recent advances in PDT to resolve the current problems. Major breakthroughs in PDTs are enabling significant progress in molecular medicine and are interconnected with innovative strategies based on smart bio/nanomaterials or therapeutic insights. We focus on newly developed PDT strategies designed by tailoring photosensitive reactive oxygen species generation, which include the use of proteinaceous photosensitizers, self-illumination, or oxygen-independent approaches. While these updated PDT platforms are expected to enable major advances in cancer treatment, addressing future challenges related to biosafety and target specificity is discussed throughout as a necessary goal to expand the usefulness of PDT.
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Affiliation(s)
- Duc Loc Sai
- Department of Life Science, Hanyang University, Seoul, 04763, Republic of Korea
| | - Jieun Lee
- Department of Life Science, Hanyang University, Seoul, 04763, Republic of Korea
| | - Duc Long Nguyen
- Department of Life Science, Hanyang University, Seoul, 04763, Republic of Korea
| | - Young-Pil Kim
- Department of Life Science, Hanyang University, Seoul, 04763, Republic of Korea.
- Department of HY-KIST Bio-Convergence, Hanyang University, Seoul, 04763, Republic of Korea.
- Research Institute for Natural Sciences, Hanyang University, Seoul, 04763, Republic of Korea.
- Research Institute for Convergence of Basic Sciences, Hanyang University, Seoul, 04763, Republic of Korea.
- Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, Republic of Korea.
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Lindholm V, Pitkänen S, Schröder M, Hahtola S, Sahi H, Halme H, Isoherranen K. Pulsed Dye Laser-mediated Photodynamic Therapy is Less Effective than Conventional Photodynamic Therapy for Actinic Field Cancerization: A Randomized Half-side Comparative Study. Acta Derm Venereol 2021; 101:adv00404. [PMID: 33491093 PMCID: PMC9366706 DOI: 10.2340/00015555-3754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Previous research presents pulsed dye laser-mediated photodynamic therapy as a promising alternative to conventional red-light photodynamic therapy. In this study, 60 patients with 2 or more actinic keratoses randomly received either of these treatments on each side of the head. A physician blinded to the treatment evaluated treatment response at 6 months for each lesion, as completely, partially or not healed. Significantly lower complete clearance rates (10.3% vs 44.9%) and lesion-specific complete clearance rates were found for pulsed dye laser-mediated photodynamic therapy (47.9%) vs conventional red-light photodynamic therapy (73.4%). Significantly lower pain scores were found for pulsed dye laser-mediated photodynamic therapy, with a mean numerical rating of 2.3, compared with 4.1 for conventional red-light photodynamic therapy. The study population had a mean of 7.9 lesions, and 78% of patients had been treated previously for actinic keratoses on the treatment area. To conclude, in a population with severe sun damage, pulsed dye laser-mediated photodynamic therapy seems less effective than conventional red-light photodynamic therapy. Pulsed dye laser-mediated photodynamic therapy may still be a treatment option for patients who are not compliant with conventional redlight photodynamic therapy.
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Affiliation(s)
- Vivian Lindholm
- Department of Dermatology and Allergology, Skin and Allergy Hospital, Helsinki University Hospital, Meilahdentie 2, FIN-00250 Helsinki, Finland. E-mail:
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48
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Karrer S, Szeimies RM, Philipp-Dormston WG, Gerber PA, Prager W, Datz E, Zeman F, Müller K, Koller M. Repetitive Daylight Photodynamic Therapy versus Cryosurgery for Prevention of Actinic Keratoses in Photodamaged Facial Skin: A Prospective, Randomized Controlled Multicentre Two-armed Study. Acta Derm Venereol 2021; 101:adv00355. [PMID: 33313936 PMCID: PMC9309835 DOI: 10.2340/00015555-3717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Actinic keratoses are a chronic condition in ultraviolet-damaged skin, with a risk of progressing to invasive skin cancer. The aim of this study was to investigate the preventive potential of field-directed repetitive daylight photodynamic therapy for actinic keratoses. A randomized trial was performed, including 58 patients with ≥5 actinic keratoses on photodamaged facial skin, who received either 5 full-face sessions of day-light photodynamic therapy within a period of 2 years or lesion-directed cryosurgery. Primary outcome was the mean cumulative number of new actinic keratoses developed between visits 2 and 6 (visit 6 being a follow-up). This outcome was lower after daylight photodynamic therapy (7.7) compared with cryosurgery (10.2), but the difference did not reach significance (–2.5, 95% confidence interval –6.2 to 1.2; p=0.18). Several signs of photoageing (fine lines, pigmentation, roughness, erythema, sebaceous gland hyperplasia) were significantly reduced after daylight photodynamic therapy, but not after cryosurgery. Significantly less pain and fewer side-effects were reported during day-light photodynamic therapy than during cryosurgery. This study found that repetitive daylight photodynamic therapy had photo-rejuvenating effects. However, the prevention of actinic keratoses by this therapy could not be proven in a statistically reliable manner.
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Affiliation(s)
- Sigrid Karrer
- Department of Dermatology, University Hospital Regensburg, DE-93053 Regensburg, Germany. E-mail:
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Ming L, Cheng K, Chen Y, Yang R, Chen D. Enhancement of tumor lethality of ROS in photodynamic therapy. Cancer Med 2021; 10:257-268. [PMID: 33141513 PMCID: PMC7826450 DOI: 10.1002/cam4.3592] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022] Open
Abstract
In the process of photodynamic therapy (PDT) treatment of tumors, reactive oxygen species (ROS) plays a key role in destroying tumor tissues. However, traditional PDT often has limited ROS killing capacity due to hypoxia in the tumor microenvironment (TME) or obstruction by the ROS defense system, resulting in poor efficacy. Therefore, enhancing the killing effect of ROS on tumors is the core of enhancing the anti-tumor effect of PDT. In recent years, many studies have developed a series of strategies to enhance the ability of ROS to kill tumors in view of the limitations of the TME on PDT. This article summarizes the commonly used or innovative strategies in recent years, including not only frequently used methods for hypoxia in the TME but also innovative strategies to inhibit the ROS defense system.
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Affiliation(s)
- Lan Ming
- Research Institute for Reproductive Health and Genetic DiseasesThe Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical UniversityWuxiChina
| | - Kai Cheng
- Research Institute for Reproductive Health and Genetic DiseasesThe Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical UniversityWuxiChina
| | - Yu Chen
- Research Institute for Reproductive Health and Genetic DiseasesThe Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical UniversityWuxiChina
| | - Rui Yang
- Research Institute for Reproductive Health and Genetic DiseasesThe Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical UniversityWuxiChina
| | - Daozhen Chen
- Research Institute for Reproductive Health and Genetic DiseasesThe Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical UniversityWuxiChina
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Rapozzi V, Bonavida B. Commentary: Photodynamic Therapy-Induced Oxidative Stress and the Circadian Rhythm. Crit Rev Oncog 2021; 26:67-73. [PMID: 35381148 DOI: 10.1615/critrevoncog.2022043185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | - Benjamin Bonavida
- Department of Microbiology, Immunology, & Molecular Genetics, David Geffen School of Medicine, Johnson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA 90025-1747, USA
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