Failure of photodynamic therapy (PDT) in 3 patients with folliculitis decalvans

Burillo-Martínez, Sara; Maroñas‐Jiménez, Lidia; Pérez, Sara; Vanaclocha-Sebastián, F.; López-Gómez, Sara

doi:10.1016/j.jaad.2015.09.075

Cited by 13 publications

(8 citation statements)

References 3 publications

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“…PDT, especially MAL-PDT, has also been proposed for FD since it presents immunomodulatory, anti-inflammatory, and bactericidal activity due to its phototoxic effects, preventing the proliferation of S. aureus apart from the well-known possible accumulation of porphyrins in the pilosebaceous unit [96] . However, studies on this topic are not so numerous [97][98][99] ( Table 5 ). The most interesting data came from Miguel-Gomez et al [98] , who performed a protocol of 4 sessions of MAL-PDT at 4-week intervals in 10 FD patients with clinical improvement in 90% of cases.…”

Section: Folliculitis Decalvansmentioning

confidence: 99%

“…Four months following the first treatment, the clinical response persisted in 60% of cases even if half of these patients required another therapy to maintain the response. The literature, however, has also shown an experience with 3 patients who were unsuccessfully treated with MAL-PDT (2 patients showed mild improvement immediately after PDT sessions but early relapse occurred before the next cycles) [99] . Limited data are available regarding PDT in the treatment of FD.…”

Section: Folliculitis Decalvansmentioning

confidence: 99%

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Photodynamic Therapy and Skin Appendage Disorders: A Review

Megna

Fabbrocini

Marasca

et al. 2016

Skin Appendage Disord

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Photodynamic therapy (PDT) is a noninvasive treatment that utilizes light treatment along with application of a photosensitizing agent. In dermatology, PDT is commonly used and approved for the treatment of oncological conditions such as actinic keratosis, Bowen disease and superficial basal cell carcinoma. In the last 2 decades however, PDT has also been used for the treatment of several nonneoplastic dermatological diseases. The present review summarizes published data on PDT application in skin appendage disorders. Our literature review shows that: (a) PDT may be a suitable treatment for acne, folliculitis decalvans, hidradenitis suppurativa, nail diseases, and sebaceous hyperplasia; (b) there is a lack of agreement on PDT features (type, concentrations and incubation period of used substances, number and frequency of PDT sessions, optimal parameters of light sources, and patient characteristics [e.g., failure to previous treatments, disease severity, body surface area involved, etc.] which should guide PDT use in these diseases); (c) further research is needed to establish international guidelines helping dermatologists to choose PDT for the right patient at the right time.

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Section: Folliculitis Decalvansmentioning

confidence: 99%

Section: Folliculitis Decalvansmentioning

confidence: 99%

Photodynamic Therapy and Skin Appendage Disorders: A Review

Megna

Fabbrocini

Marasca

et al. 2016

Skin Appendage Disord

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“…Then the prepared 10% ALA was applied on the treatment regions and 1 cm surrounding areas with a clean brush. It was retained for at least 3 hours, under occlusion with a dark saran wrap to avoid light irradiation . After removal of the 10% ALA, the treated scalp was exposed to a narrow‐band red light (633 ± 10 nm, LED‐IB, Wuhan Yage Ltd, China) (Fig.…”

Section: Methodsmentioning

confidence: 99%

Treatment of dissecting cellulitis of the scalp with 10% ALA‐PDT

et al. 2018

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“…PDT displays strong antimicrobial effects, with little or no resistance. Topical PDT has been used in the treatment of FD, with the largest case series showing clinical improvement in 9 of the 10 patients enrolled, but smaller series have shown less positive results …”

Section: Reportmentioning

confidence: 99%

Systemic photodynamic therapy in folliculitis decalvans

et al. 2017

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SummaryFolliculitis decalvans (FD) is classified as a primary neutrophilic cicatricial alopecia, and is estimated to account for approximately 10% of all cases of primary cicatricial alopecia. 1 The role of dysfunctional immune activity and the presence of bacteria, particularly Staphylococcus aureus, appear pivotal. We describe a 26-year-old man with a 4-year history of FD that was recalcitrant to numerous systemic and topical therapies, whose disease was virtually cleared during a follow-up of 25 months following a course of treatment with systemic photodynamic therapy (PDT) using ultraviolet light (100-140 J/cm 2 ) with porfimer sodium 1 mg/kg as monotherapy. This is the first report of the use of systemic PDT as a treatment for FD. Systemic PDT has potent antibacterial effects with little or no resistance. In addition, systemic PDT provides local immunomodulation and improved scar healing. Significant adverse effects following systemic PDT with appropriate aftercare are rare. This case demonstrates that systemic PDT is a useful therapy option in the treatment of recalcitrant FD.Folliculitis decalvans (FD) is classified as a primary neutrophilic cicatricial alopecia, which accounts for approximately 10% of all cases of primary cicatricial alopecia.1 Dysfunctional immune activity and the presence of bacteria, particularly Staphylococcus aureus, appear to play pivotal roles. We report a case of FD in a young man who was successfully treated with systemic photodynamic therapy (PDT). ReportA 26-year-old man presented in 2011 with a 4-year history of waxing and waning painful pustulation, hair tufting and scarring, all affecting the vertex of the scalp. He was otherwise healthy. Histological examination of a biopsy taken from the scalp showed evidence of scarring alopecia with superficial follicular and perifollicular abscesses (Fig. 1a). Staining showed Numerous gram-positive bacteria within inflamed hair follicles, and an absence of fungi were evident. Multiple microbacterial swabs from active scalp pustules grew methicillin-sensitive S. aureus. Fungal cultures were negative, as was a screen of connective tissue and skin autoantibodies for bullous pemphigoid and pemphigus.Treatment over the next 3 years involved oral antibiotics (doxycycline, rifampicin and clindamycin), retinoids (isotretinoin and acitretin), prednisolone and ciclosporin. Topical treatments included antibacterial washes, topical antibiotics and topical corticosteroids. Despite these treatments, the disease remained active, with a significant impact on quality of life. The patient was referred for consideration of radiotherapy, a treatment with previously demonstrated effectiveness in FD. 2During the assessment, the patient's youth made it preferable to avoid radiotherapy and instead he was offered a trial of systemic PDT with porfimer sodium (Photofrin, Axcan Pharma Inc, Quebec, Canada) as a novel alternative.

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Failure of photodynamic therapy (PDT) in 3 patients with folliculitis decalvans

Cited by 13 publications

References 3 publications

Photodynamic Therapy and Skin Appendage Disorders: A Review

Photodynamic Therapy and Skin Appendage Disorders: A Review

Treatment of dissecting cellulitis of the scalp with 10% ALA‐PDT

Systemic photodynamic therapy in folliculitis decalvans

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