SummarySkin rejuvenating effects of photodynamic therapy (PDT) for photoaged skin has been well-documented in several clinical trials. Different photosensitizers (5-aminolevulinic acid, methyl aminolevulinate) and diverse light sources (light-emitting diodes, lasers, intense pulsed light) have been used with promising results. An improvement of lentigines, skin roughness, fine lines and sallow complexion has been achieved with PDT. These clinically evident effects are at least in part due to histologically proven increase of collagen and decrease of elastotic material in the dermis. Effective improvement of photoaged skin, simultaneous treatment and possibly also prevention of actinic keratoses, the possibility of repeated treatments and, in contrast to other procedures, limited and calculable side effects make PDT a promising procedure for skin rejuvenation.
Sigrid
SummaryIn addition to providing effective treatment for non-melanoma skin cancers or their precursors, photodynamic therapy (PDT) has also attracted considerable attention for its use on aesthetic dermatology. In a first consensus publication the mechanisms of action of its photorejuvenation effects and recent studies were presented; in this paper treatment protocols for the different anatomical regions exposed to chronic sun damage like face, neck, décolleté and the back of the hands are given and suitable procedures for pre-and after-care are discussed.
Focal hyperhidrosis can have a considerable impact on social and occupational activities and be associated with significant impairment in quality of life. Primary (idiopathic) hyperhidrosis is neither caused by systemic disorders nor by external factors. It usually occurs in areas characterized by a high density of sweat glands such as the axillae and hands. The diagnosis of focal hyperhidrosis is based on history and clinical findings. Supplementary diagnostic tests include gravimetry (measurement of the amount of sweat) and the iodine starch test (which shows the area of sweating). Treatment options consist of topical agents, botulinum toxin A injections, iontophoresis, treatment with radiofrequency, microwaves, or ultrasound as well as surgical procedures (axillary suction curettage, sympathectomy). Systemic agents such as anticholinergics may also be used. Selection of the most appropriate therapeutic approach depends on the site affected, prior treatment as well as the patient's requests.
Zusammenfassung
Die fokale Hyperhidrose kann zu erheblichen sozialen und beruflichen Einschränkungen und damit zu einer ausgeprägten Verminderung der Lebensqualität führen. Der primären Hyperhidrose liegen keine internistischen Erkrankungen oder externen Ursachen zugrunde. Sie tritt vor allem im Bereich von Arealen mit einer großen Schweißdrüsendichte wie den Achseln und den Händen auf. Die Diagnose der Hyperhidrose basiert auf der Anamnese und der Klinik. Unterstützt wird die Diagnostik durch Gravimetrie (die Schweißmengenmessung) und den Iod‐Stärke‐Test (der das vom Schwitzen betroffene Areal definiert). Zur Behandlung der primären Hyperhidrose stehen eine Reihe von Verfahren wie die topische Therapie, die Injektionstherapie mit Botulinumtoxin A, die Leitungswasser‐Iontophorese, die Therapie mit Radiofrequenz, Mikrowellen oder Ultraschall bis hin zu den operativen Interventionen wie der axillären Saugkürettage oder der Sympathektomie zur Verfügung. Auch systemische Therapeutika (vor allem Anticholinergika) kommen zur Anwendung. Die Auswahl der geeigneten Behandlungsmaßnahmen sollte individuell auf die Lokalisation, die vorangegangen Behandlungen und die Wünsche des Patienten abgestimmt werden.
In addition to providing effective treatment for non-melanoma skin cancers or their precursors, photodynamic therapy (PDT) has also attracted considerable attention for its use on aesthetic dermatology. In a first consensus publication the mechanisms of action of its photorejuvenation effects and recent studies were presented; in this paper treatment protocols for the different anatomical regions exposed to chronic sun damage like face, neck, décolleté and the back of the hands are given and suitable procedures for pre- and after-care are discussed.
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