RESUMO
While conventional in-office phototherapy has long been utilized as a successful treatment for atopic dermatitis (AD), it is associated with potential barriers including inconvenience, poor adherence, time and financial expense. In this retrospective study, we examine the efficacy, adherence, and patient-satisfaction of using adjunctive at-home, self-administered phototherapy utilizing a novel handheld narrow-band ultraviolet B (NB-UVB) device for the treatment of refractory mild to severe AD. Included AD patients were initially trained on proper use of the device. These patients treated involved areas three times per week for a period of 12 weeks. Phototherapy dosing protocol was based on skin type. The cohort included 52 patients, who were aged 20-69 and represented all skin types. They were initially categorized by disease involvement as mild, moderate, and severe. Patients were also queried to self-score their disease severity and level of satisfaction. Compared to baseline, at 12 weeks, 48% percent of patients indicated that at least one site was Clear/Almost Clear, 38% stated that more than 50% of body locations were Clear/Almost Clear, and 28% reported that 100% (all) treated sites were Clear/Almost Clear. After using at-home hand-held NB-UVB for the study duration, 67% (35/52) of patients experienced disease improvement. Mean overall satisfaction was extremely high at 4.43 on a 5-point scale. Skin type, age, gender, and disease severity at inception did not significantly affect patient satisfaction scores. Overall adherence rate among participants across all groups was 73%. In this small retrospective study, at-home handheld NB-UVB phototherapy was found to be an effective, well-tolerated, adjunctive treatment method for patients with refractory AD, which was associated with a high level of patient satisfaction and adherence.
Assuntos
Dermatite Atópica , Satisfação do Paciente , Terapia Ultravioleta , Humanos , Dermatite Atópica/radioterapia , Dermatite Atópica/terapia , Dermatite Atópica/diagnóstico , Adulto , Feminino , Masculino , Estudos Retrospectivos , Terapia Ultravioleta/métodos , Terapia Ultravioleta/instrumentação , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Resultado do Tratamento , Índice de Gravidade de Doença , Cooperação do Paciente/estatística & dados numéricosRESUMO
Phototherapy clinics administer ultraviolet (UV) light to patients using phototherapy cabinets. The UV radiation from these cabinets is reflected on the white ceiling tiles of the clinic and is then redirected toward both staff and patients in the area. This is particularly problematic for clinical technologists who must undertake dosimetry in these areas and have a specific time (often as low as 30â min) before they reach their maximum exposure limit. By replacing white tiles with black ones, which absorb any stray radiation, we were able to reduce stray reflection by almost 90%, prolonging the time to maximum exposure by nearly 10 times. We present these findings to encourage other similar clinics to undertake the simple protocols outlined in this article, which will significantly improve staff and patient safety.
Assuntos
Exposição Ocupacional , Raios Ultravioleta , Humanos , Exposição Ocupacional/prevenção & controle , Raios Ultravioleta/efeitos adversos , Terapia Ultravioleta/instrumentação , Terapia Ultravioleta/métodos , Fototerapia/instrumentação , Fototerapia/métodosAssuntos
Desinfecção , Raios Ultravioleta , Terapia Ultravioleta , Qualidade de Produtos para o Consumidor , Desinfecção/instrumentação , Desinfecção/métodos , Raios Ultravioleta/efeitos adversos , Terapia Ultravioleta/efeitos adversos , Terapia Ultravioleta/instrumentação , Estados Unidos , United States Food and Drug AdministrationAssuntos
Hiperpigmentação/prevenção & controle , Semicondutores , Terapia Ultravioleta/instrumentação , Linhagem Celular , Proliferação de Células/efeitos da radiação , Fibroblastos/efeitos da radiação , Humanos , Hiperpigmentação/etiologia , Melanócitos/efeitos da radiação , Pigmentação da Pele/efeitos da radiação , Terapia Ultravioleta/efeitos adversosAssuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Terapia Ultravioleta , COVID-19 , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Física Médica , Humanos , Pneumonia Viral/transmissão , Radiometria , Raios Ultravioleta , Terapia Ultravioleta/instrumentação , Terapia Ultravioleta/métodosRESUMO
Ultraviolet A1 (UVA1 ) phototherapy (spectral range 340-400 nm) is a well-established treatment option for various skin diseases such as localized scleroderma. Recent improvements of conventional UVA1 light sources (metal-halide or fluorescent lamps) have brought attention to a new light-emitting diode (LED) technology with remarkable advantages in handling and clinical routine. This study provides a preclinical histological and molecular evaluation of an LED-based UVA1 prototype with a narrower spectral range (360-400 nm) for treating localized scleroderma. Scleroderma mouse models and fibroblasts in vitro were exposed to LED-based UVA1 phototherapy or to irradiation with a commercially available metal-halide lamp emitting low-dose (20, 40 J/cm2 ), medium-dose (60 J/cm2 ) and high-dose (80, 100 J/cm2 ) UVA1 light. Both UVA1 light sources affected inflammatory genes (IL-1α and IL-6) and growth factors (TGFß-1 and TGFß-2). Increased collagen type 1 was reduced after UVA1 phototherapy. Matrix metalloproteinase-1 was more enhanced after a medium dose of LED-based UVA1 phototherapy than after conventional treatment. In vivo, dermal thickness and the amount of collagen were reduced after both treatment methods. Remarkably, myofibroblasts were more effectively reduced by a medium dose of LED-based UVA1 phototherapy. The study indicates that LED-based UVA1 phototherapy yields similar or even better results than conventional treatment. In terms of biosafety and patient comfort, LED-based UVA1 phototherapy offers clear advantages over conventional treatment because of the use of a narrower and less harmful UVA1 spectrum, less heat generation and shorter treatment times at the same irradiation intensity. Clinical studies are required to confirm these results in patients with localized scleroderma.
Assuntos
Fibroblastos/efeitos da radiação , Expressão Gênica/efeitos da radiação , Esclerodermia Localizada/radioterapia , Terapia Ultravioleta/instrumentação , Actinas/metabolismo , Animais , Bleomicina , Sobrevivência Celular/efeitos da radiação , Células Cultivadas , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Modelos Animais de Doenças , Fibroblastos/patologia , Fibroblastos/fisiologia , Humanos , Interleucina-1alfa/genética , Interleucina-6/genética , Masculino , Metaloproteinase 1 da Matriz/genética , Metaloproteinase 1 da Matriz/metabolismo , Camundongos , Miofibroblastos/metabolismo , RNA Mensageiro/metabolismo , Esclerodermia Localizada/induzido quimicamente , Esclerodermia Localizada/patologia , Fator de Crescimento Transformador beta1/genética , Fator de Crescimento Transformador beta2/genética , Raios UltravioletaAssuntos
Autocuidado/métodos , Terapia Ultravioleta/métodos , Vitiligo/diagnóstico , Vitiligo/radioterapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fototerapia/instrumentação , Fototerapia/métodos , Projetos Piloto , Estudos Prospectivos , Autocuidado/instrumentação , Resultado do Tratamento , Terapia Ultravioleta/instrumentação , Adulto JovemRESUMO
A novel model of the skin dose in whole-body UV phototherapy treatment cabins is presented. The model is based on an analysis of the thermal radiation exchange between two surfaces, in this case the UV source and the patient. It is shown to allow analytical treatment of the multiple internal reflections in a treatment cabin that account for around 40% of the skin irradiance. The model provides predictions of the absolute irradiance at the skin and shielding factors in seven different UVA and NB-UVB cabins that are within 6% of those measured using a calibrated radiometer and within 12% for all nine cabins. The model predicts reducing skin irradiances with increasingly patient size, a trend demonstrated in clinical measurements. The exact sensitivity to patient size in automated cabin dosimetry systems, however, varies with in-built sensor positioning. The potential to extend the use of the model to investigate improved design of automated dosimetry systems is discussed.
Assuntos
Modelos Teóricos , Pele/efeitos da radiação , Temperatura , Terapia Ultravioleta/métodos , Irradiação Corporal Total/métodos , Humanos , Doses de Radiação , Terapia Ultravioleta/instrumentaçãoRESUMO
OBJECTIVE: To measure adherence using a novel home UVB phototherapy system designed to promote adherence. STUDY DESIGN: A retrospective, observational study conducted to evaluate patients' adherence to a prescribed three-times-per-week treatment protocol using a novel home phototherapy system with integrated features designed to improve adherence. METHODS: Data was collected from 18 psoriasis patients, 27 vitiligo patients, and three atopic dermatitis patients using a novel home phototherapy system under normal use conditions. Adherence was also calculated using two alternative methods to allow for comparison between published phototherapy adherence studies. RESULTS: The median patient adherence (N= 48) to treatment with the home phototherapy system was 80%. There were no significant differences in adherence between different ages, genders, or diseases (P>0.05). Early adherence (N=48) to the home phototherapy system was 90% and dichotomous adherence (N=32) was 71%. CONCLUSIONS: By implementing a smartphone application and web-based portal with the home phototherapy system, patients have multiple mechanisms in place to ensure adherence.
Assuntos
Dermatite Atópica/radioterapia , Cooperação do Paciente/estatística & dados numéricos , Psoríase/radioterapia , Terapia Ultravioleta/métodos , Vitiligo/radioterapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Portais do Paciente , Fototerapia/métodos , Estudos Retrospectivos , Smartphone , Terapia Ultravioleta/instrumentaçãoRESUMO
Development of photothermal materials which are able to harness sunlight and convert it to thermal energy seems attractive. Besides carbon-based nanomaterials, conjugated polymers are emerging promising photothermal materials but their facile syntheses remain challenging. In this work, by modification of a CBT-Cys click condensation reaction and rational design of the starting materials, we facilely synthesize conjugated polymers poly-2-phenyl-benzobisthiazole (PPBBT) and its dihexyl derivative with good photothermal properties. Under the irradiation of either sunlight-mimicking Xe light or near-infrared laser, we verify that PPBBT has comparable photothermal heating-up speed to that of star material single-wall carbon nanotube. Moreover, PPBBT is used to fabricate water-soluble NPPPBBT nanoparticles which maintain excellent photothermal properties in vitro and photothermal therapy effect on the tumours exposed to laser irradiation. We envision that our synthetic method provides a facile approach to fabricate conjugated polymers for more promising applications in biomedicine or photovoltaics in the near future.
Assuntos
Hipertermia Induzida/métodos , Nanopartículas/efeitos da radiação , Neoplasias/terapia , Nanomedicina Teranóstica/métodos , Terapia Ultravioleta/métodos , Animais , Linhagem Celular Tumoral/transplante , Terapia Combinada/métodos , Modelos Animais de Doenças , Feminino , Humanos , Hipertermia Induzida/instrumentação , Lasers , Camundongos , Camundongos Endogâmicos BALB C , Microscopia Eletrônica de Transmissão , Nanopartículas/administração & dosagem , Nanopartículas/química , Nanopartículas/ultraestrutura , Polímeros/administração & dosagem , Polímeros/química , Polímeros/farmacocinética , Polímeros/efeitos da radiação , Distribuição Tecidual , Resultado do Tratamento , Terapia Ultravioleta/instrumentaçãoRESUMO
BACKGROUND: Phototherapy is effective in treating psoriasis and other skin conditions. However, clinic-based phototherapy can be time-consuming, expensive, and inconvenient. Conventional home phototherapy addresses many hurdles, but has other limitations. OBJECTIVE: Assess the treatment efficacy, adherence, and satisfaction of a novel ultraviolet B home phototherapy system. METHODS: Eight patients with stable plaque psoriasis completed a multicenter, prospective, open label, interventional study using a home phototherapy device designed to improve treatment control and adherence. Matched control and study lesions were assessed on each subject. A dosing protocol based on American Academy of Dermatology guidelines for narrowband UVB phototherapy was managed by the phototherapy system. Responsiveness to the treatment was measured using the Psoriasis Severity Index (PSI) at 10 weeks versus control. Patient satisfaction was graded on a five-star Likert scale. RESULTS: At 10 weeks, all patients experienced improvement in the treated lesions, with a mean improvement of 57% in PSI (P<0.0001 compared to baseline and P<0.0002 compared to the control lesions). Patient treatment adherence was 96% and treatment satisfaction was 100% five-star rated. Control lesions did not significantly change in PSI over the 10-week period (P=0.1411). CONCLUSIONS: The home phototherapy system provided a safe and effective means to manage plaque psoriasis.
Assuntos
Psoríase/radioterapia , Autocuidado , Terapia Ultravioleta/métodos , Humanos , Aplicativos Móveis , Cooperação do Paciente , Satisfação do Paciente , Índice de Gravidade de Doença , Smartphone , Terapia Ultravioleta/efeitos adversos , Terapia Ultravioleta/instrumentaçãoAssuntos
Lasers de Excimer/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Linfoma de Células B/radioterapia , Neoplasias Cutâneas/radioterapia , Terapia Ultravioleta/métodos , Idoso de 80 Anos ou mais , Face , Feminino , Humanos , Terapia com Luz de Baixa Intensidade/instrumentação , Resultado do Tratamento , Terapia Ultravioleta/instrumentaçãoRESUMO
Phototherapy utilizes the beneficial effects of ultraviolet (UV) wavelengths to affect immunoregulatory functions. UV light phototherapy using narrowband UV-B (NB-UVB) and bath-psoralen UV-A (bath-PUVA) therapy are well-established treatments for psoriasis. Dual-action mechanisms of UV phototherapy have been identified: apoptosis and immune suppression. NB-UVB depletes pathogenic T cells by inducing apoptosis and regulatory T cells. Other wavelengths are also utilized for phototherapy, namely 308-nm excimer light and 312-nm flat-typed NB-UVB. Excimer light (308-nm) therapy effectively targets the affected skin without unduly exposing other areas and increases the levels of regulatory T cells. Phototherapy improves impaired resting regulatory T cells and increases activated regulatory T cells in patients with psoriasis. Intensive studies of phototherapy effects have led to several improvements in the design, protocols, and light sources, such as UV light-emitting diodes, thereby providing several options for patients with refractory skin disease, such as psoriasis.
Assuntos
Psoríase/terapia , Pele/efeitos da radiação , Linfócitos T/efeitos da radiação , Terapia Ultravioleta/métodos , Apoptose/efeitos da radiação , Fármacos Dermatológicos/uso terapêutico , Humanos , Fármacos Fotossensibilizantes/uso terapêutico , Psoríase/imunologia , Pele/citologia , Pele/imunologia , Linfócitos T/imunologia , Resultado do Tratamento , Terapia Ultravioleta/instrumentaçãoRESUMO
BACKGROUND: Antibiotic resistance is one of the most serious health threats to modern medicine. The lack of potent antibiotics puts us at a disadvantage in the fight against infectious diseases, especially those caused by antibiotic-resistant microbial strains. To this end, an urgent need to search for alternative antimicrobial approaches has arisen. In the last decade, light-based anti-infective therapy has made significant strides in this fight to combat antibiotic resistance among various microbial strains. This method includes utilizing antimicrobial blue light, antimicrobial photodynamic therapy, and germicidal ultraviolet irradiation, among others. Light-based therapy is advantageous over traditional antibiotics in that it eradicates microbial cells rapidly and the likelihood of light-resistance development by microbes is low. METHODS: This review highlights the patents on light-based therapy that were filed approximately within the last decade and are dedicated to eradicating pathogenic microorganisms. The primary database that was used for the search was Google Patents. The searches were performed using the keywords including blue light, antimicrobial photodynamic therapy, ultraviolet irradiation, antibiotic resistance, disinfection, bacterium, fungus, and virus. RESULTS: Forty-five patents were obtained in our search: 9 patents for the antimicrobial blue light approach, 21 for antimicrobial photodynamic therapy, 11 for UV irradiation, and lastly 4 for other light-based anti-infective approaches. The treatments and devices discussed in this review are interestingly enough able to be used in various different functions and settings, such as dental applications, certain eye diseases, skin and hard surface cleansing, decontamination of internal organs (e.g., the stomach), decontamination of apparel and equipment, eradication of pathogenic microorganisms from buildings and rooms, etc. Most of the devices and inventions introduce methods of destroying pathogenic bacteria and fungi without harming human cells and tissues. CONCLUSIONS: Light-based antimicrobial approaches hold great promise for the future in regards to treating antibiotic-resistant infections and related diseases.
Assuntos
Anti-Infecciosos/uso terapêutico , Patentes como Assunto , Fotoquimioterapia/instrumentação , Fotoquimioterapia/métodos , Fototerapia/instrumentação , Fototerapia/métodos , Terapia Ultravioleta/instrumentação , Terapia Ultravioleta/métodos , Resistência Microbiana a Medicamentos/efeitos dos fármacos , HumanosRESUMO
The use of ultraviolet (UV) light, for the treatment of skin conditions, dates back to the early 1900s. It is well known that sunlight can be of therapeutic value, but it can also lead to deleterious effects such as burning and carcinogenesis. Extensive research has expanded our understanding of UV radiation and its effects in human systems and has led to the development of man-made UV sources that are more precise, safer, and more effective for the treatment of wide variety of dermatologic conditions.
Assuntos
Lasers/história , Fotoquimioterapia/história , Dermatopatias/história , Raios Ultravioleta/história , Terapia Ultravioleta/história , Animais , Desenho de Equipamento , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Lasers/efeitos adversos , Segurança do Paciente , Fotoquimioterapia/efeitos adversos , Fotoquimioterapia/instrumentação , Doses de Radiação , Exposição à Radiação/história , Fatores de Risco , Dermatopatias/tratamento farmacológico , Dermatopatias/radioterapia , Resultado do Tratamento , Raios Ultravioleta/efeitos adversos , Terapia Ultravioleta/efeitos adversos , Terapia Ultravioleta/instrumentaçãoRESUMO
The effects of ultraviolet radiation on human skin have been studied for years, and both its harmful and therapeutic effects are well known. Exposure to UV light can lead to sunburn, immunosuppression, skin aging, and carcinogenesis, and photoprotection is strongly advocated. However, when used under controlled conditions, UV radiation can also be helpful in the diagnosis and treatment of many skin conditions.
Assuntos
Dermatologia/métodos , Lasers , Dermatopatias/radioterapia , Pele/efeitos da radiação , Raios Ultravioleta , Terapia Ultravioleta , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Lasers/efeitos adversos , Fatores de Risco , Pele/metabolismo , Pele/patologia , Dermatopatias/diagnóstico , Dermatopatias/metabolismo , Resultado do Tratamento , Raios Ultravioleta/efeitos adversos , Terapia Ultravioleta/efeitos adversos , Terapia Ultravioleta/instrumentação , Terapia Ultravioleta/métodosRESUMO
The exposure to ultraviolet radiations and visible light, or phototherapy, is a well-known therapeutic tool available for the treatment of many dermatological disorders. The continuos medical and technological progresses, of the last 50 years, have involved the field of phototherapy, which evolved from UVA and PUVA in its various forms, to the development of narrowband UVB (NB-UVB) and NB-UVB micro-focused phototherapies. Further advances in technology have now permitted the introduction of a new device emitting UVA-1 radiations.