New topical photodynamic therapy for treatment of hidradenitis suppurativa using methylene blue niosomal gel: a single-blind, randomized, comparative study

Fadel, Maha; Tawfik, Abeer Attia

doi:10.1111/ced.12459

Cited by 55 publications

(50 citation statements)

References 15 publications

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“…The modified Sartorius score (MSS) has been partially validated as a tool to assess disease severity; however, it can be considered time‐consuming to use, and several versions of this score have been developed with inconsistent use of terminology, leading to confusion among physicians. For example, modified HS score (modified HSS), MSS and HS‐LASI (HS lesion, area and severity index) are all used . The HiSCR has more validation data than other traditional severity tools; however, a further validated tool to assess cross‐sectional severity in HS has recently been developed …”

Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Zouboulis

Bechara

Dickinson-Blok

et al. 2018

Acad Dermatol Venereol

176

273

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Hidradenitis suppurativa (HS)/acne inversa is a debilitating chronic disease that remains poorly understood and difficult to manage. Clinical practice is variable, and there is a need for international, evidence-based and easily applicable consensus on HS management. We report here the findings of a systematic literature review, which were subsequently used as a basis for the development of international consensus recommendations for the management of patients with HS. A systematic literature review was performed for each of nine clinical questions in HS (defined by an expert steering committee), covering comorbidity assessment, therapy (medical, surgical and combinations) and response to treatment. Included articles underwent data extraction and were graded according to the Oxford Centre for Evidence-based Medicine criteria. Evidence-based recommendations were then drafted, refined and voted upon, using a modified Delphi process. Overall, 5310 articles were screened, 171 articles were analysed, and 65 were used to derive recommendations. These articles included six randomized controlled trials plus cohort studies and case series. The highest level of evidence concerned dosing recommendations for topical clindamycin in mild disease (with systemic tetracyclines for more frequent/widespread lesions) and biologic therapy (especially adalimumab) as second-line agents (following conventional therapy failure). Good-quality evidence was available for the hidradenitis suppurativa clinical response (HiSCR) as a dichotomous outcome measure in inflammatory areas under treatment. Lower-level evidence supported recommendations for topical triclosan and oral zinc in mild-to-moderate HS, systemic clindamycin and rifampicin in moderate HS and intravenous ertapenem in selected patients with more severe disease. Intralesional or systemic steroids may also be considered. Local surgical excision is suggested for mild-to-moderate HS, with wide excision for more extensive disease. Despite a paucity of good-quality data on management decisions in HS, this systematic review has enabled the development of robust and easily applicable clinical recommendations for international physicians based on graded evidence.

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Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Zouboulis

Bechara

Dickinson-Blok

et al. 2018

Acad Dermatol Venereol

176

273

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“…The clinical heterogeneity of HS suggests that its response to treatment will be heterogeneous. Among others photosensitizers, excellent results were obtained with methylene blue [66,67] , toluidine blue [68] , neutral red [69] , rose bengal [70] , and tetrasubstituted N-methyl-pyridylporphine [71] . Several authors reported studies on patients with HS treated with the protocol based on ALA-PDT and MAL-PDT as photosensitizers and light sources at 635 nm [70][71][72][73] .…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

“…Niosomes are nonionic surfactant-based liposomes and, as a novel drug delivery system, can play an important role in improving the topical delivery of photosensitizers. Fadel and Tawfik [67] enrolled 11 patients with HS in their study, which was a randomized splitbody study: one side of an anatomical site was randomized to receive niosomal methylene blue (NMB) gel PDT or free methylene blue (FMB) gel PDT once every 2 weeks for up to 6 months. Drug release from the FMB gel was significantly higher ( p > 0.05) than from the NMB gel.…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

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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“…18 Increase in treatment sessions may also achieve good response for the early stage of HS. Fadel et al reported topical PDT using methylene blue niosomal gel improved HS and even for Hurley stage three of HS 19 which means novel photosensitizer may increase the e±cacy of PDT for HS.…”

Section: Discussionmentioning

confidence: 99%

Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

Zhang

Wang

Shi

et al. 2016

J. Innov. Opt. Health Sci.

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Acne conglobata (AC), perifolliculitis capitis abscedens et su®odiens (PCAS) and hidradenitis suppurativa (HS) are uncommon refractory chronic, in°ammatory, scarring diseases but cause serious damage to the quality of life. These three diseases are associated with follicular occlusion. Several studies indicated topical 5-aminolevulinic acid photodynamic therapy (ALA-PDT) improved follicular occlusion besides acne treatment. So we attempted to apply ALA-PDT to medicine resistant AC, PCAS and HS. Topical ALA-PDT was applied to 10 patients with AC, seven patients with PCAS and three patients with HS for more than three sessions. All the patients completed the dermatology life quality index (DLQI) questionnaire and were assessed for the e±cacy at the baseline and on two weeks after each treatment. Adverse e®ects were recorded at each visit. The results showed 25.5% (5/20, two cases of AC and three cases of PCAS) of patients achieved excellent improvement after three sessions of PDT and another 60. HS) got poor response (< 20% lesions clearance). Another¯ve cases (three cases of AC and two cases of PCAS) also achieved excellent response after 5-7 sessions of PDT. We also found that papular/nodular, cyst/abscess showed higher clearance rate than sinus/¯stula (88.5%, 86.1% versus 11.1%). DLQI was reduced after three sessions of PDT in AC and PCAS patients rather than HS patients. 5-ALA-PDT could improve refractory AC and PCAS but could not lead to improvement in late stage of HS. The e±cacy increased with more treatment sessions.

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New topical photodynamic therapy for treatment of hidradenitis suppurativa using methylene blue niosomal gel: a single-blind, randomized, comparative study

Cited by 55 publications

References 15 publications

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Photodynamic Therapy and Skin Appendage Disorders: A Review

Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

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