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INTRODUCTION: Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AKs) on the face and scalp in adults to ensure excellent patient tolerability due to the mild side effects and the brief application time compared to other topical therapies on the market. A growing body of evidence suggests that, beyond their primary function, the treatments for AKs and the cancerization field may inadvertently confer substantial cosmetic benefits to patients. METHODS: We report a single-center retrospective case series of patients referred to the Dermatology Unit of the University Hospital of Messina, Italy, between February and December 2023 seeking treatment for AKs in the context of photodamaged areas in which the application of tirbanibulin 1% ointment induced, besides clearance of AKs, anti-aging effects on both skin texture and solar lentigos. RESULTS: Seven patients affected by Olsen grade 1-2 AKs experienced a powerful rejuvenating effect in the treated areas, with a marked efficacy in skin lightening and clearance of solar lentigo. CONCLUSIONS: Tirbanibulin 1% ointment seems able to improve skin aging as a desirable side effect at the site of application for AKs on chronic photodamaged skin. Such preliminary observation needs further confirmation in real-life studies on larger cohorts of patients, to explain the pathogenic mechanisms responsible for such aesthetically relevant results.
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BACKGROUND: Acral warts appear as skin-colored, verrucous, hyperkeratotic papules most located on the dorsal hands, distal fingers, subungual skin, and feet. Conventional photodynamic therapy (C-PDT) has shown a good efficacy and safety profile in patients with viral warts, in both adults and children, with a good cure rate and excellent cosmetic results in front of few and light side effects. The efficacy of daylight photodynamic therapy (DL-PDT) has not yet been evaluated. OBJECTIVES: to investigate and assess the short- and long-term efficacy of PDT using 10% aminolevulinic acid (ALA) in the treatment of multiple verrucae vulgaris of the hands. The second endpoint was to compare the efficacy and safety of C-PDT versus DL-PDT. MATERIALS AND METHODS: 68 patients (38 males and 30 females) aged between 6 and 80 years, affected by hand warts, were divided into two arms: group A was treated with C-PDT, and group B was treated with DL-PDT. Patients underwent treatments three times at 1-month intervals. The response was assessed 3 months after the last session (W24) and 1 year after the last session (W52) and scored as excellent (75-100% reduction of total wart count), partial (74-25% reduction), and none (< 25% reduction or no response). Any adverse events occurring during or after ALA application or irradiation as well as pain intensity were recorded at each visit. RESULTS: 48 patients (70.6%) achieved excellent response at W24, while 6 patients (8.8%) had a partial response and 14 (20.6%) were resistant to treatment. Patients treated with DL-PDT were less likely to have an excellent response (66.7%) than patients treated with C-PDT (73.7%), although not statistically significant. Among patients with excellent or partial response (n=54), 37% (n=20) had warts relapse at W52. Both treatment modalities were well tolerated, with transient pain as the main side effects. CONCLUSION: PDT is effective in the treatment of verrucae vulgaris of the hands. An overall response rate of 70.6% of excellent response was achieved. While C-PDT showed a trend towards better outcomes, DL-PDT offered a more patient-friendly approach, particularly in terms of comfort and compliance.