Hui Deng MD PhD, Dingfen Yuan MD, Chunlin Yan MD, Xiaoxi Lin MD PhD, Xu’an Ding MD
Objective: To evaluate the efficacy and safety of a 2940 nm fractional photothermolysis laser in the treatment of acne scarring in
Methods: Twenty-six patients with moderate-to-severe atrophic scarring were treated with a 2940 nm-wavelength fractional photothermolysis
Results: All patients had encouraging results. Both skin elasticity and moisture content increased significantly after five treatments.
In post-treatment evaluations, both the patients treated, as well as an independent group of physicians each scored the atrophic scar
improvement as significant.
Conclusion: The 2940 nm fractional photothermolysis laser is safe and effective in the treatment of acne scarring.
Maha Fadel PhD, Manal Salah MD, Nevien Samy PhD, Mona Soliman MD
Background: Photodynamic therapy (PDT) has been proposed as a treatment option for acne vulgaris. The authors have proposed in
this work a liposomal delivery for methylene blue (MB) for selective acne treatment.
Objectives: To evaluate the efficacy and tolerability of liposomes loaded methylene blue (LMB) based photodynamic therapy in patients
with mild-to-moderate acne vulgaris in a randomized, controlled and investigator blinded study.
Materials and methods: Liposomes loaded methylene blue (LMB) was prepared and studied for different pharmaceutical properties
and formulated in hydrogel (MB 0.1%). Permeability and selective sebaceous gland targeting in mice skin was studied. Gel containing
LMB was used for treating 13 patients complaining of mild-moderate acne vulgaris once a week for two weeks. Efficacy evaluation
included changes in lesions counts, clinical assessments of clinical improvement by patients and evaluating dermatologists. Pain and
local adverse effects were also evaluated.
Results: The mechanism of the drug released from liposomes (both in pH=5.5 and in pH=7.2) was following zero order kinetics
with significant increase in the drug released in pH=5.5. Drug released from free methylene blue (FMB) gel was significantly higher
(P≤0.05) with Higuichi’s diffusion model than LMB gel, which followed zero order kinetics. Free MB gel showed superficial destruction
in the mice hair shaft while LMB showed complete destruction of pilosebaceous unit. After only two sessions, there was a
83.3% reduction in the number of inflammatory acne lesions and a 63.6% reduction in the number of non-inflammatory acne lesions.
At 12 weeks, 90% of patients had a moderate-to-marked improvement of their acne in the treated areas. Most patients had no pain;
also no serious adverse side effects were recorded. All the patients had no edema. Slight transient hyperpigmentation was seen only
in three patients.
Conclusion: Liposomal MB hydrogel selectively delivered MB to sebaceous gland and was effective in photodynamic treatment of
mild-to-moderate acne vulgaris.
Karin Caekelbergh MSc, Arjen F. Nikkels MD PhD, Bernard Leroy MD, Evelien Verhaeghe MD, Mark Lamotte MD, Vincent Rives PharmD
Background: Basal cell carcinoma (BCC) is the most common form of skin cancer worldwide. Different treatment options exist. The
efficacy of photodynamic therapy with methyl aminolevulinate (MAL-PDT) has been established in several randomized controlled trials
(RCTs). Real life data can differ greatly from data derived from randomized controlled trials (RCTs).
Objectives: To describe the results of a Belgian observational study concerning superficial BCC (sBCC) vis-à-vis clinical and health
economic outcomes in order to evaluate the real-life practice of MAL-PDT.
Methods: This study was a prospective, single-arm, open study conducted at eight dermatological institutions during six months after
the first MAL-PDT treatment. Eligible patients had to present with lesions, suitable for MAL-PDT according to Belgian reimbursement
criteria. Resource use was collected during the study period. Clinical Response (CR) and Cosmetic Outcome (CO), as well as cost of
care were evaluated. A subset analysis of patients with sBCC only was conducted.
Results: Ninety patients were identified for the analysis (mean age 65 years; 61% female). The mean number of lesions per patient
was 1.6, mostly located on the face, the back and the chest. For the entire period, the mean number of visits to a dermatologist was
4 per patient including two MAL-PDT sessions. The average, cumulative amount of MAL used per treatment was 1,256 mg. Two
patients experienced adverse events at the application site, none of them serious; all resolved completely. The CR rate was 89% at
the end of the study. The CO was “excellent” or “good” in 96% of the patients. Total cost of care was €289 ($414 U.S.) per patient.
Cost per lesion was €195 ($280 U.S.).
Conclusion: The results from the real-life practice study confirm the efficacy found in prior, prospective randomized trials. About four
visits and less than one tube of MAL are needed for the full treatment of sBCC in one patient.
David B. Vasily MD, Mary E. Cerino RN, Ethel M. Ziselman MD, Zeina S. Tannous MD
Objective: Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis
to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm
erbium:glass fractional laser in the treatment of surgical and post-traumatic scars.
Methods: Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional
laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical
scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar
tissue, as compared to baseline histology of the scar.
Results: Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue
with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick
skin types II–V, received three to seven treatments with microbeam energies up to 60 mJ/μb and five passes. Relative to baseline, 73%
of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema
(94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects.
Conclusion: These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical
and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual
Christy C. Riddle MD, Shaundre N. Terrell BS, Molly B. Menser DO, Daniel J. Aires MD,Eric S. Schweiger MD
Background: Photodynamic therapy (PDT) is increasing in dermatology. Antibiotic resistance and the challenges of isotretinoin
therapy have led to investigation of PDT in the treatment of acne vulgaris.
Objective: To review the results of clinical trials and case series with respect to light source, topical photosensitizing agent, adverse
events, efficacy and skin type.
Methods: A non-critical review is presented of a PubMed search for studies examining PDT in the treatment of acne vulgaris.
Results: The authors found 21 clinical trials and case series of various designs. Eight studies employed a split-face design comparing
photosensitizer to placebo, no treatment or another photosensitizer. Two trials used three test spots and one control spot per patient.
Three studies utilized control subjects receiving no photosensitizer with or without light therapy. All 21 studies reported a reduction in
inflammatory lesions and/or a significant improvement in acne. The light sources utilized included blue light, pulsed-dye laser (PDL),
intense pulsed light (IPL) and red light. Studies comparing the use of PDT to light therapy alone demonstrated greater improvement
in treatment groups pretreated with a photosensitizer.
Conclusion: All studies reported reduction in inflammatory lesions or significant improvement in acne. Several studies confirm a
light source combined with photosensitizer is superior to light alone. Adverse reactions including photosensitivity, pustular eruptions,
and crusting varied among photosensitizers and light sources. PDT appears to be a useful therapeutic option for acne patients who
are recalcitrant to standard treatments and poor candidates for systemic retinoids. Further studies are still needed before a consensus
protocol can be established. Additional investigations are needed to establish optimal incubation time, activating light source and
frequency of treatment.
Joel Lee Cohen MD FAAD and Ashish C. Bhatia MD FAAD
Background and Objective: Facial purpura is a frequent barrier to patient acceptance and satisfaction with the results of various
cosmetic procedures. Methods to shorten the duration of purpura after such procedures are often sought by patients. This study
evaluated the efficacy and safety of a topical gel containing vitamin K oxide in the resolution of laser induced purpura.
Methods: In this randomized, double-blinded, placebo-controlled split-face study, 20 subjects with bilateral facial telangiectasia were
treated with a pulsed dye laser (PDL) device at purpuric settings. The test articles, a gel containing vitamin K oxide and placebo (vehicle),
were each randomly assigned to one side of the subject’s face. Subjects applied the test articles twice a day for the following
9 ± 1 days. Improvement in both focal and general field purpura on each side of the face was assessed by the investigator using
photographs. A scale of -100% (worsening) to 100% (improving) was used to rate photos against a baseline photograph obtained
15–30 minutes after treatment with the PDL device.
Results: Resolution of the field of purpura was consistently greater with the vitamin K oxide gel after the second day of treatment.
The greatest difference between the vitamin K oxide gel and placebo scores occurred on the fourth day after treatment. Although differences
in active versus placebo scores did not reach statistical significance during the nine-day study period, a trend toward faster
resolution of purpura with the active product was seen. Treatment-related adverse effects were not observed in any subject.
Conclusion: Vitamin K oxide gel appears to hasten the resolution of pulsed dye laser-induced purpura in subjects being treated for
bilateral facial telangiectasia, and may well be useful in accelerating resolution of facial bruising from other cosmetic procedures such
as fillers used for soft-tissue augmentation as well as other types of cutaneous surgical procedures.
No abstract details for the moment.
No abstract details for the moment.
No abstract details for the moment.