Clinical and histopathological characteristics, diagnosis and treatment, and comorbidities of Bowen's disease: a retrospective study.

Background: Bowen's disease (BD) is a slow-growing precancerous skin condition, often concurrent with other diseases, with a high misdiagnosis rate. Previous studies show that patients with BD in different populations have differentiated characteristics. Materials and methods: A retrospective study was conducted in a tertiary hospital in Shenzhen, China. Data about demographic information, diagnosis and treatment, clinical and pathological characteristics, and comorbidities of 50 patients with BD were collected and analyzed. Results: Clinical data of onset age and disease course of 43 patients with BD were available, the average onset age of male and female patients are 55.1 (standard deviation (SD) = 15.29) and 58.2 (SD = 15.59) years old, respectively; the average disease course of male and female patients are 25.3 (SD = 28.63) and 33.9 (SD = 49.65) months, respectively. The onset age (p = 0.52) and disease course (p = 0.49) between male and female patients are not significantly different. Interestingly, there is a negative correlation between onset age and disease course (r = -0.245, p = 0.11). The correct rate of clinical diagnosis is relatively low (54.00%); Some patients with BD are misdiagnosed as Bowenoid papulosis (10.00%), actinic keratosis (8.00%), basal cell carcinoma (8.00%), seborrheic keratosis (6.00%), and pigmented naevus (4.00%). Trunk and limbs are the most common distribution sites of BD lesions, and 94.00% patients with BD are treated with surgical resection; 66.00% patients with BD had comorbidities, including skin diseases (48.48%), cardiovascular diseases (39.39%), gastrointestinal diseases (30.30%), respiratory diseases (27.27%), and tumors (18.18%). The most commonly observed histopathological characteristics of BD are squamous-cell hyperplasia (86.00%), disordered maturation with atypical keratinocytes (74.00%), atypical mitoses (60.00%), hyperkeratosis with hypokeratosis (48.00%), dermal inflammatory cell infiltration (36.00%), and koilocytosis (22.00%). Conclusion: BD often occurs in middle-aged and elderly people and is easily misdiagnosed. The onset age and disease course of patients with BD are not significantly different between males and females, whereas there is a negative correlation between the onset age and disease course. BD is more likely to occur in trunk and limbs in the Chinese population, and most patients with BD are concurrent with comorbidities.

Acitretin enhances the cytotoxic effect of 5-aminolevulinic acid photodynamic therapy on squamous cell carcinoma cells.

The efficacy of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) on invasive cutaneous squamous cell carcinoma (cSCC) remains to be improved due to the limited penetration of this treatment. Previous study showed that acitretin and ALA-PDT had synergistic effect on cSCC, but whether acitretin can enhance the cytotoxic effect of ALA-PDT on cSCC is unclear. OBJECTIVE: To investigate whether acitretin can enhance the cytotoxic effect of ALA-PDT on SCL-1 cells, as well as the possible mechanism involved. METHODS: Inverted microscopy, trypan blue exclusion assay, and flow cytometry were used to studied the morphology, viability and apoptosis of SCL-1 cells treated with acitretin, ALA-PDT and acitretin followed by ALA-PDT treatment, respectively. Confocal microscopy was applied to detect the ROS formation of SCL-1 cells treated with acitretin of four different concentrations. The ROS formation of SCL-I cells treated with acitretin of four different concentrations followed by ALA-PDT treatment was detected using confocal microscopy and flow cytometry. RESULTS: SCL-1 cells exhibited a significant morphological alteration when treated with acitretin followed by ALA-PDT. The combination of acitretin and ALA-PDT induced a higher cell death rate and apoptosis than that with acitretin or ALA-PDT treatment alone. ROS could be induced when incubated with acitretin at a concentration of 6.4 × 10-4mg /mL or above. However, a higher level of ROS formation was observed when SCL-1 cells were treated with acitretin followed by ALA-PDT than that with ALA-PDT or acitretin alone. CONCLUSION: Acitretin can enhance the cytotoxic effect of ALA-PDT on SCL-1 cells, possibly via the ROS pathway.

Successful treatment of oral condyloma acuminata with photodynamic therapy: Two case reports.

Oral condyloma acuminatum (OCA) is a less prevalent subtype of condyloma acuminatum and is challenging to treat. We reported two cases of OCA successfully treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). After three treatments spaced one week apart, both cases were completely cured without significant adverse reactions and were followed up for one year with no recurrence.

Comparing HMME-PDT and Cynergy dual-wavelength laser in the treatment of facial PWS.

BACKGROUND: Pulsed dye laser (PDL) is the gold-standard therapy for port-wine stains (PWSs), but the therapeutic efficacies vary widely with each individual. Recent studies suggest that hematoporphyrin monomethyl ether-photodynamic therapy (HMME-PDT) is an effective alternative in the treatment of PWS. This retrospective study aimed to compare the effects of HMME-PDT and Cynergy dual-wavelength laser on red and purple color types of PWS METHODS: This retrospective study included 38 PWS patients who received Cynergy dual-wavelength laser treatment (PDL group) and 39 PWS patients who received HMME-PDT treatment (HMME-PDT group). Patients in each group received two treatments. The curative effect of purple or red PWS in two groups was analyzed. RESULTS: After the first treatment, the total significant response rate and the total response rate of the HMME-PDT group were 43.59% and 74.36%, which were significantly higher than those of the PDL group (5.26% and 47.36%) (P < 0.05). After the second treatment, the total significant response rate and the total response rate of the HMME-PDT group were 69.23% and 100%, which were obviously higher than those of the PDL group (34.21% and 68.42%) (P < 0.05). For both groups, the total significant response rate of purple-type PWS was remarkably higher than that of red-type PWS (the HMME-PDT group: P = 0.004; the PDL group: P = 0.048). There was no obvious difference in terms of patient age and PWS location between the HMME-PDT and PDL groups. Furthermore, there was no considerable difference in the incidence of adverse reactions between the two groups (P > 0.05). CONCLUSION: The single-center retrospective study suggested that HMME-PDT might have better efficacies on purple and red PWS than PDL treatment. The total treatment efficacy was greater in purple-type PWS than in red-type PWS.

5-aminolevulinic acid photodynamic therapy inhibits invasion and metastasis of SCL-1 cells probably via MTSS1 and p63 gene related pathways.

OBJECTIVE: To investigate the effect of 5-aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) on the invasion and metastasis in cutaneous squamous cell carcinoma (cSCC) cell line(SCL-1) and to study whether the effect was via the MTSS1 gene and p63 gene related pathways. METHODS: SCL-1 cells were cultured and submitted to ALA-PDT treatment (ALA-PDT group), ALA treatment alone (ALA group), LED illumination alone (LED group) and remains untreated (control group). Scratch test, Transwell migration chamber assay and Matrigel cell invasion assay were used to detect the ability of migration and invasion of SCL-1 cells after treatment. The mRNA levels and protein expressions of tumor metastasis suppressor gene (MTSS1) and p63 gene were further detected by using quantitative real-time PCR and flow cytometry assay respectively after treatment. RESULTS: The migration and invasion abilities of SCL-1 cells after treatment were significantly reduced in the ALA-PDT groups than that in ALA group, LED group and control group (P＜0.05). Both the mRNA and protein expression levels of MTSS1 gene were up-regulated, while the mRNA and protein expression levels of p63 gene were down-regulated after ALA-PDT treatment. CONCLUSION: ALA-PDT suppressed the migration and invasion of human cSCC cell line, probably via the MTSS1 gene and p63 gene related pathways. This study put forward a possible mechanism of invasion in SCL-1 cell, also providing a potential target for the therapy of cSCC.

5-aminolevulinic acid photodynamic therapy enhance the effect of acitretin on squamous cell carcinoma cells: An in vitro study.

Squamous cell carcinoma (SCC) remains the second most common nonmelanoma skin cancer (NMSC) worldwide. Both acitretin and 5-Aminolevulinic acid mediated photodynamic therapy (ALA-PDT) have validated effect on SCC. However, the effects of both treatmens remain limited, and there has been no report concerning the potential synergistic effect of both treatments for SCC. OBJECTIVE: To investigate the cytotoxic effect of acitretin on SCL-1 cells, and whether ALA-PDT enhances this effect. METHODS: CCK-8 and trypan blue exclusion array were used to detect the cell cytotoxicity after acitretin treatment with different concentrations (1.6 × 10-4mg/mL, 1.6 × 10-3 mg/mL, 1.6 × 10-2mg/mL and 1.6 × 10-1mg/mL) for 24 h, 48 h and 72 h. Flow cytometry and trypan blue exclusion assay were used to detect the apoptosis and viability of SCL-1 cells after treated with acitretin, ALA-PDT and ALA-PDT immediately followed by acitretin. Independent sample t test was used to analyze the different incubation time of acitretin and acitretin combined with ALA-PDT on SCL-1 cells. Bonferroni Test One-way Anova method was used to analyze the effect of different treatment on the SCL-1 cells. RESULTS: A significant cytotoxic effect was observed after acitretin treatment, in an acitretin concentration-dependent manner within the range of 1.6 × 10-4mg/mL to 1.6 × 10-1mg/mL and an acitretin incubation time-dependent manner within 24 h-72 h. The total apoptosis rate and dead cells rate in group of ALA-PDT combined with acitretin were both significantly higher than that of acitretin, ALA-PDT group. A stronger apoptotic and cytotoxic effect detected 24 h after treated with acitretin than that of 12 h was observed in this study. CONCLUSION: Acitretin has a cytotoxic effect on SCL-1 cells, and ALA-PDT treatment enhances the the cytotoxic effect of acitretin.