Effectiveness of cross polarized light and fluorescence diagnosis for detection of sub‐clinical and clinical actinic keratosis during imiquimod treatment

Ortonne, Jean‐Paul; Gupta, Girish; Ortonne, Nicolas; Duteil, L.; Queille, Catherine; Mallefet, Pascal

doi:10.1111/j.1600-0625.2009.01047.x

Cited by 22 publications

(19 citation statements)

References 25 publications

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“…It is now known that, in addition to lesions which are clinically visible, the entire area of sun-exposed skin frequently contains multiple subclinical or macroscopically invisible lesions, meaning that the entire burden of disease cannot be directly seen [1][2][3]. In addition, AK lesions are no longer deemed to be a cosmetic problem, but instead are considered by some experts to be in situ squamous cell carcinoma (SCC) which can progress into invasive SCC and which may eventually be at risk of metastasizing [1,[4][5][6].…”

mentioning

confidence: 99%

Reduction in lesions from Lmax: a new concept for assessing efficacy of field-directed therapy for actinic keratosis. Results with imiquimod 3.75%

Stockfleth

Gupta

Peris

et al. 2014

European Journal of Dermatology

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Reduction in lesions from Lmax: a new concept for assessing efficacy of field-directed therapy for actinic keratosis. Results with imiquimod 3.75%Background: Current parameters for assessing the efficacy of actinic keratosis (AK) treatments compare clinical lesions at the start and end of a study. However, the sun-exposed field also contains subclinical lesions which may become detectable during treatment. Lmax, the maximum lesion count during treatment, is a new concept to better assess the efficacy of field-directed AK therapies. Measuring efficacy using the reduction in lesions from Lmax includes for the first time the clearance of both subclinical and clinical lesions. Objectives: To evaluate the reduction of lesions from Lmax to study end and compare the results with traditional efficacy endpoints using imiquimod 3.75% (IQ3.75%) as an example of field-directed AK therapy. Materials & Methods: Pooled analysis of data from two 14-week, vehicle-controlled, double-blind studies of IQ3.75%. Results: With IQ3.75%, the median number of lesions increased from 10 at baseline to an Lmax of 22. The median absolute reduction in lesions to study end was 18 from Lmax versus 7 from baseline. The median percentage reduction in AK lesions to study end was 92.2% from Lmax compared with 81.8% from baseline. Conclusions: The reduction in lesion count from Lmax is a novel efficacy parameter that should become the new way of evaluating field-directed AK therapies since it enables their efficacy against both clinical and subclinical lesions to be accurately determined. Together, the Lmax concept and IQ3.75% represent a new approach for the management of AK across a large sun-exposed field.

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confidence: 99%

Reduction in lesions from Lmax: a new concept for assessing efficacy of field-directed therapy for actinic keratosis. Results with imiquimod 3.75%

Stockfleth

Gupta

Peris

et al. 2014

European Journal of Dermatology

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“…Well-established clinical observations have demonstrated the effect of polarized light on the significant acceleration of epithelialization, increase in collagen production, and the reorganization of the extracellular matrix [7]. Positive results have been reported recently concerning the application of polarized light in treating keratosis [8]. Research conducted with molecular and immunological methods also shows that polarized light selectively stimulates the cell division of fibroblasts and biosynthesis of collagen [9].…”

Section: Introductionmentioning

confidence: 82%

Genome-wide gene expression study indicates the anti-inflammatory effect of polarized light in recurrent childhood respiratory disease

Falus

Fenyő²,

Éder

et al. 2011

Inflamm. Res.

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“…Among these, polarized light photography is a well-known technique that uses the polarization of the light reflected from skin tissues. It can be applied to evaluate skin diseases such as acne vulgaris, photoaging, subclinical actinic keratosis, nonmelanoma skin cancer, subclinical levels of skin irritant reactions, and psoriasis78910.…”

Section: Discussionmentioning

confidence: 99%

Rosacea Subtypes Visually and Optically Distinct When Viewed with Parallel-Polarized Imaging Technique

et al. 2017

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BackgroundParallel-polarized light (PPL) photography evaluates skin characteristics by analyzing light reflections from the skin surface.ObjectiveThe aim of this study was to determine the significance of quantitative analysis of PPL images in rosacea patients, and to provide a new objective evaluation method for use in clinical research and practice.MethodsA total of 49 rosacea patients were enrolled. PPL images using green and white light emitting diodes (LEDs) were taken of the lesion and an adjacent normal area. The values from the PPL images were converted to CIELAB coordinates: L* corresponding to the brightness, a* to the red and green intensities, and b* to the yellow and blue intensities.ResultsA standard grading system showed negative correlations with L* (r=−0.67862, p=0.0108) and b* (r=−0.67862, p=0.0108), and a positive correlation with a* (r=0.64194, p=0.0180) with the green LEDs for papulopustular rosacea (PPR) types. The xerosis severity scale showed a positive correlation with L* (r=0.36709, p=0.0276) and a negative correlation with b* (r=−0.33068, p=0.0489) with the white LEDs for erythematotelangiectatic rosacea (ETR) types. In the ETR types, there was brighter lesional and normal skin with white LEDs and a higher score on the xerosis severity scale than the PPR types.ConclusionThis technique using PPL images is applicable to the quantitative and objective assessment of rosacea in clinical settings. In addition, the two main subtypes of ETR and PPR are distinct entities visually and optically.

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Effectiveness of cross polarized light and fluorescence diagnosis for detection of sub‐clinical and clinical actinic keratosis during imiquimod treatment

Cited by 22 publications

References 25 publications

Reduction in lesions from Lmax: a new concept for assessing efficacy of field-directed therapy for actinic keratosis. Results with imiquimod 3.75%

Reduction in lesions from Lmax: a new concept for assessing efficacy of field-directed therapy for actinic keratosis. Results with imiquimod 3.75%

Genome-wide gene expression study indicates the anti-inflammatory effect of polarized light in recurrent childhood respiratory disease

Rosacea Subtypes Visually and Optically Distinct When Viewed with Parallel-Polarized Imaging Technique

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