Efficacy of Alpha and Beta Hydroxy Acid Chemical Peels in Postacne Pigmentation: A Double Blinded, Randomized, Controlled Trial.

Background: Acne is one of the most commonly faced dermatological complaints in our day-to-day practice. Among the various treatment modalities for acne and postacne pigmentation, chemical peeling is a promising and emerging treatment modality. Although various peeling agents are available, there is a lack of research comparing their efficacy. In addition, only a few studies have compared the efficacy of combined peels in the South Indian population. The present study aimed to compare the efficacy of alpha and beta hydroxy acid peels in the treatment of postacne pigmentation. Methods: Forty patients with postacne pigmentation were divided into two groups of 20 patients each. Patients were randomized into one of the two treatment groups consecutively based on block randomization technique with block size 4. Patients of GA peel group was treated with 50% glycolic acid (GA) and the salicylic acid (SA) peel group was treated with 30% salicylic acid. The procedure was repeated every two weeks up to six weeks and the primary outcome was assessed every two weeks. The assessment with photographic documentation was done by a blinded evaluator from our department of dermatology. Results: The mean age of the study population was 21±2.29 years. Out of 40 patients, 24 were females and 16 were males. GA and SA peel groups showed significant improvement from first follow-up onwards in the study. However, GA peel showed higher percentage of postacne pigmentation reduction than SA peel in all the four follow-ups. In GA peel group, >75% reduction in postacne pigmentation was observed in 45 percent of the patients. Whereas in the SA peel group, none of the patients achieved >75% reduction of postacne pigmentation. Pairwise comparison between both groups were statistically significant (P<0.0001). Conclusion: Our results suggest that the GA peel was more effective than SA peel in improving postacne pigmentation.

In vitro Effect of Photodynamic Therapy with Curcumin and Methylene Blue Photosensitizers on Staphylococcus Aureus.

Statement of the Problem: Staphylococcus aureus (S.A) can colonize in the skin, nasal cavity, and oral cavity. In the oral cavity, it can cause dental caries and periodontal disease. Mouthwashes can be used as an adjunct to mechanical plaque control methods to decrease the load of oral microorganisms. Chlorhexidine (CHX) is a commonly used antimicrobial mouthwash with side effects such as changing the sense of taste, tooth discoloration, oral mucosal burning, allergy, and xerostomia. It also has adverse systemic effects, if swallowed. Purpose: This study aimed to assess the effect of photodynamic therapy (PDT) with curcumin and methylene blue (MB) photosensitizers and different laser parameters on S.A colony count. Materials and Method: In this in vitro experimental study, 99 samples of standard-strain S.A were subjected to PDT with curcumin and MB photosensitizers with/without irradiation of 660 and 445 nm laser with different exposure parameters, and CHX in 9 groups (n=11). The samples were cultured in microplates containing Mueller-Hinton agar, and the number of colony forming units (CFUs) was counted after 24 h of incubation at 37°C. Data were analyzed by the Kruskal-Wallis and Dunn tests. Results: The minimum colony count was noted in CHX group (CFUs=0) followed by MB and 660nm diode laser group irradiated for 100 s (CFUs=147.2727±169.35707). The difference in this respect was significant between MB+660nm diode laser for 100 s and other groups (p< 0.05) except for the MB + 660 nm diode laser for 60 s group. Conclusion: CHX is superior to laser for elimination of S.A. However, PDT with 660 nm diode laser + MB has considerable antimicrobial efficacy against S.A; increasing the duration of laser irradiation enhances the antimicrobial effect.

Photodynamic Therapy for Actinic Keratoses of the Upper Extremities using 10% Aminolevulinic Acid Gel, Red Light, and Adapalene Pretreatment.

BACKGROUND: Actinic keratoses (AKs) are sun-induced cutaneous lesions that may progress to squamous cell carcinoma (SCC). Photodynamic therapy (PDT) is an ideal treatment option for AKs because it allows for treatment of field cancerization, selective destruction of diseased tissue, good cosmetic outcomes, and limited downtime. OBJECTIVES: This study sought to determine the efficacy and safety of pretreating AKs of the dorsal hands and forearms with adapalene gel, an inexpensive and over-the-counter retinoid, prior to debridement of the target area and PDT with aminolevulinic hydrochloride acid (ALA, 10%) gel and narrowband red light. METHODS: Fifteen patients with AK lesions of the right or left dorsal hands or forearms were pretreated with adapalene gel (0.1%) twice daily for one week prior to ALA-PDT. The other hand or forearm was treated with ALA-PDT (standard therapy), but not pretreated. For PDT, all treated areas were debrided with sandpaper, degreased with acetone, incubated for one hour with 10% ALA gel under occlusion, and illuminated with narrowband red light (~635 nm). All patients experienced one PDT treatment session. RESULTS: Eight weeks after treatment, 12 subjects in the adapalene-pretreated group achieved 50% to 100% clearance compared to 10 subjects in the standard therapy group. The median lesion count reduction in the adapalene-pretreated group was -79% compared to -57% in the standard therapy group, and this difference was significant (P=0.0164). The treatment was well-tolerated and the level of patient satisfaction was high. CONCLUSIONS: Pretreatment with adapalene gel twice daily for one week may enhance efficacy in a single ALA-PDT treatment of AK lesions of the dorsal hand or forearm.

The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial.

OBJECTIVES: The aim of the present randomized controlled split-mouth clinical trial is to evaluate the effectiveness of the adjunctive use of photodynamic low-level laser therapy (670 nm), applying methylene blue as photosensitizer, and the effectiveness of a diode laser (940 nm) compared with conventional non-surgical mechanical treatment in a group of patients with chronic periodontal disease. MATERIALS AND METHODS: Twenty-one patients with moderate to severe periodontal disease with presence of 3 or more quadrants, each containing at least three sites with periodontal pocket depth (PPD) of ≥ 5 mm, were included in the study. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (control group), SRP with diode laser (diode group), and SRP with photodynamic therapy (photodynamic group). RESULTS: All treatment modalities in this study lead to statistically significant improvements in the evaluated clinical parameters at 3 months and 6 months compared with baseline. There was no statistically significant difference regarding PD and BOP between groups. There was only a tendency for greater reduction of PD in the diode group for deep pockets at 3 months, but not statistically significant. CONCLUSIONS: After 6 months of evaluation, the high intensity diode laser and the antimicrobial photodynamic therapy have not shown any additional benefits to the conventional periodontal treatment. CLINICAL RELEVANCE: The diode or photodynamic laser therapy in conjunction with conventional SRP does not seem to be superior in reducing probing depth and bleeding on probing than SRP alone 6 months after treatment. More studies are necessary to prove the actual need of these types of lasers in the periodontal clinical practice.

Proinflammatory effects of photoactivated methylene blue on rat model of Walker 256 carcinosarcoma

Photodynamic therapy (PDT) is an anticancer therapy that associates the photosensitizer (PS), oxygen and light to destroy cancer cells. Methylene blue (MB) is considered a second generation phenothiazine dye with excellent photochemical properties. Aim: To evaluate whether MB-mediated PDT can induce oxidative stress and inflammation, therefore, interfering tumor growth. Materials and Methods: The study was conducted on Wistar rats transplanted with Walker 256 carcinosarcoma (W256). The proinflammatory interleukins levels (IL-1ß, IL-6, IL-10, TNF-a) were determined by ELISA, mRNA expression of COX-1, COX-2, iNOS and eNOS by RT-PCR, lipid peroxidation was measured by the TBARS method. Moreover, myeloperoxidase (MPO) activity in neutrophils was determined by MPO activity assay. All indices mentioned above were determined in tumor tissue. Kaplan — Meier and Gehan — Breslow — Wilcoxon tests were used for survival analysis. Results: We found that the treatment of W256 with 0.1% MB + 1 J/cm2 provoked a significant increase in the interleukins levels (IL-1ß, IL-6, IL-10, TNF-a), prostaglandin E2, the mRNA expression of COX-2, iNOS, lipid peroxidation and MPO activity in tumor tissue, which were statistically different (p < 0.05) compared to other experimental and control groups. The results of the estimation of survival curves show a greater probability of survival in 0.1% MB + 1 J/cm2 (total energy dose =142.8 J/cm2 ) treated group. Conclusion: Our results suggest that treatment of W256 with 0.1% MB + 1 J/cm2 was able to promote cytotoxic effects in tumor tissue by the generation of reactive oxygen species causing inflammation and thus interfering in the tumor growth

Effect of Nonsurgical Periodontal Treatment Combined With Diode Laser or Photodynamic Therapy on Chronic Periodontitis: A Randomized Controlled Split-Mouth Clinical Trial.

INTRODUCTION: The optimum removal of bacteria and their toxins from periodontal pockets is not always obtained by conventional mechanical debridement. Adjunctive therapies may improve tissue healing through detoxification and bactericidal effects. The purpose of the present study was to evaluate the impact of adjunctive laser therapy (LT) and photodynamic therapy (PDT) on patients with chronic periodontitis. METHODS: Twenty patients with at least three quadrants involved and each of them presenting pockets 4-8 mm deep were included in the study. Periodontal treatment comprising scaling and root planning (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (group A), SRP with LT (group B), and SRP with PDT (group C). The clinical indices were measured at baseline 6 weeks and 3 months after treatment. Microbiological samples were taken and evaluated at baseline and 3-month follow-up. RESULTS: All groups showed statistically significant improvements in terms of clinical attachment level (CAL) gain, periodontal pocket depth (PPD) reduction, papilla bleeding index and microbial count compared to baseline (P < .05). The results showed more significant improvement in the 6-week evaluation in terms of CAL in groups B and C than in group A (P < .05). Group B also revealed a greater reduction in PPD than the other treatment modalities (P < .05). CONCLUSION: The obtained data suggested that adjunctive LT and PDT have significant short-term benefits in the treatment of chronic periodontitis. Furthermore, LT showed minimal additional advantages compared to PDT.

5-Aminolevulinic acid-based fluorescence diagnostics of cervical preinvasive changes.

The purpose of this article is to review the diagnostic possibilities of 5-aminolevulinic acid (5-ALA)-based fluorescence diagnosis of preinvasive cervical changes. Reviewed papers were selected from the PubMed database with keywords combining the terms individual cervical neoplasia and fluorescence diagnostics. The regular colposcopy procedure lacks specificity; therefore, new methods are continually sought for superior diagnosis of cervical pathology. 5-ALA-based fluorescence diagnostics is under investigation as an up-to-date diagnostic technique for cervical intraepithelial neoplasia (CIN). This method is grounded on the topical or systemic application of 5-ALA, which induces excess production of the endogenous photosensitizer protoporphyrin IX (PpIX) in tissues where carcinogenesis has begun. The conversion of PpIX to the heme is less efficient in tumors; therefore, higher amounts of PpIX tend to accumulate in premalignant and malignant tissues. Illumination with light of the appropriate wavelength initiates excitation of PpIX fluorescence, which in turn helps to localize PpIX-rich areas and identify potentially malignant tissues. A number of investigations suggest that because of its high selectivity for tumors and low toxicity to healthy tissues, 5-ALA-based diagnosis seems a promising tool for the noninvasive identification of cervical intraepithelial neoplasia.

Study on Selective Depletion of Alloreactived Lymphocytes by Aminolevulinic Acid-Photodynamic Therapy / 实用儿科临床杂志

Objective To explore the effect of aminolevulinic acid-based photodynamic therapy(ALA-PDT) on alloreactived peripheral blood mononuclear cells(PBMCs).Methods Human PBMCs from different healthy donor were collected and mixed in the one-way mixed lymphocyte culture(MLC) for 5 days. The cells were harvested and aminolevulinic acid(ALA) were added into ALA group and ALA+Light group with ultimate concentrations of 0.5 mmol/L,1.0 mmol/L,1.5 mmol/L,2.0 mmol/L and 2.5 mmol/L.After cultured for 2 hours, 4 hours and 6 hours respectively in 37 ℃ 5% carbon dioxide incubator,Light group and ALA+Light group were irradiated by light of 410 nm wavelength for 1 hour.The MLC cells were treated with the former stimulator cells for 48 hours.The survival of stimulator cells were detected using MTT colorimetric assay and the kill rates of treated cells were calculated.Results The kill rate of ALA+Light group on stimulators was apparently lower than those of Light group, ALA group and control group, (33.0?26.5)% vs (87.1?2.2)%,(89.2?2.5)%,(90.3?1.9)%(All P

Anticancer Effect and Apoptosis Mechanism of Photochemotherapy Using Photogem and 632 nm Diode Laser on Human Squamous Cell Carcinoma Cell Line / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was conducted to investigate the anticancer effect of photochemotherapy in vitro using a photosensitizing agent (Photogem) and a laser therapy (632 nm diode laser). MATERIALS AND METHOD: Human squamous cell carcinoma cell (SNU-1041) was treated to laser therapy for various irradiation times, laser powers, and interval times. The treated cell was analyzed by MTT assay, DAPI staining to see apoptosis. RESULTS: The viability of cells was decreased with the increasing of the laser irradiation time and the laser power. No significant difference in cell viability was noted by various interval time. Increasing apoptosis was observed by increasing concentration of Photogem and increasing lasering time by DAPI staining. CONCLUSION: This study demonstrated anticancer effect of photochemotherapy using Photogem and 632 nm diode laser. Apoptosis was observed in the process of cancer cell death.