Photodynamic therapy of acne vulgaris with topical δ-aminolaevulinic acid and incoherent light in Japanese patients

Itoh, Yoshiyasu; Ninomiya, Yoshiharu; Tajima, S.; Ishibashi, Akira

doi:10.1046/j.1365-2133.2001.04086.x

Cited by 196 publications

(148 citation statements)

References 14 publications

(24 reference statements)

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“…Improvements usually started 3 weeks after PDT first session. Almost at the same time, other authors showed ALA-PDT efficacy in acne treatment, reporting also that improvements lasted for at least 6 months and that 1 PDT session may be not enough [20,21] . Nevertheless, almost 16 years have passed since the first studies on ALA-PDT in acne therapy; there is still no consensus on how to perform PDT for acne treatment, and its use still remains an off-label option for acne patients [22] .…”

Section: Acnementioning

confidence: 74%

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: Acnementioning

confidence: 74%

Photodynamic Therapy and Skin Appendage Disorders: A Review

Megna

Fabbrocini

Marasca

et al. 2016

Skin Appendage Disord

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“…Preliminary clinical trials point out that direct blue light-phototherapy brings about a significant decrease in the progress of acne lesions [103]. Moreover, since ALA accumulates in sebaceous glands, PDT performed after topical application of ALA is claimed to be even more effective in the treatment of acne with reduction in the sebum production and the size of the glands; the regular skin structure is fully recovered after PDT, the only post-PDT persistent changes being represented by a decrease in the number of pilosebaceous units, as shown by studies performed on Japanese patients [104]. The beneficial action of PDT appears to include the destruction of Propionibacterium spp.…”

Section: Acne Vulgarismentioning

confidence: 84%

Photodynamic therapy in the treatment of microbial infections: Basic principles and perspective applications

et al. 2006

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Background and Objectives: Photodynamic therapy (PDT) appears to be endowed with several favorable features for the treatment of infections originated by microbial pathogens, including a broad spectrum of action, the efficient inactivation of antibiotic-resistant strains, the low mutagenic potential, and the lack of selection of photoresistant microbial cells. Therefore, intensive studies are being pursued in order to define the scope and field of application of this approach. Results: Optimal cytocidal activity against a large variety of bacterial, fungal, and protozoan pathogens has been found to be typical of photosensitizers that are positively charged at physiological pH values (e.g., for the presence of quaternarized amino groups or the association with polylysine moieties) and are characterized by a moderate hydrophobicity (n-octanol/water partition coefficient around 10). These photosensitizers in a micromolar concentration can induce a > 4-5 log decrease in the microbial population after incubation times as short as 5-10 minutes and irradiation under mild experimental conditions, such as fluence-rates around 50 mW/cm 2 and irradiation times shorter than 15 minutes. Conclusions: PDT appears to represent an efficacious alternative modality for the treatment of localized microbial infections through the in situ application of the photosensitizer followed by irradiation of the photosensitizer-loaded infected area. Proposed clinical fields of interest of antimicrobial PDT include the treatment of chronic ulcers, infected burns, acne vulgaris, and a variety of oral infections.

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“…Vacuolization and degeneration of sebaceous glands were found after ALA-PDT for treatment of acne 20,21 . Itoh et al 21 inferred tissue-damage mechanism is apoptosis-like oxidative damage. PDT has been reported to treat tumors by inducing apoptosis 22 .…”

Section: Discussionmentioning

confidence: 99%

Topical ALA-Photodynamic Therapy for Acne Can Induce Apoptosis of Sebocytes and Down-regulate Their TLR-2 and TLR-4 Expression

et al. 2011

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Background: Although photodynamic therapy (PDT) is widely performed for acne, little is known about its exact therapeutic mechanism. Objective: We aimed to estimate the efficacy and safety of PDT on acne and to discover its mode of action. Methods: We performed PDT on 12 patients with mild to moderate acne. The clinical efficacy was assessed by counting the acne lesions and measuring the sebum secretion before and after PDT. In addition, we took biopsy samples from the peri-lesional areas before and after 3-session of PDT. To examine the degree of apoptosis of the sebaceous follicles, TUNEL assay was performed. To investigate the changes of toll-like receptor (TLR)-2 and TLR-4 expression after PDT, immunohistochemical stainings were also carried out. Finally, we performed TUNEL assay using the cultured sebocytes to confirm the apoptosis of sebocytes in vitro after PDT. Results: There was a significant reduction in the number of inflammatory acne lesions after PDT, compared to baseline (p＜0.05). Sebum excretion significantly decreased 2 weeks after the first PDT session except for one patient (p＜0.05). The TUNEL positive cells in the peri-lesional sebaceous glands after PDT markedly increased, compared with those of before PDT. A decrease in TLR-2 and TLR-4 expression by sebaceous glands and epidermis after PDT was 50% and 30%, respectively. Conclusion:Our results demonstrate that apoptosis of the sebaceous glands is associated with improvement of acne by PDT. PDT has shown to down-regulate TLR-2 and TLR-4 expression in the sebaceous glands and epidermis of acne patients. (Ann Dermatol 23(1) 23∼32, 2011)

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Photodynamic therapy of acne vulgaris with topical δ-aminolaevulinic acid and incoherent light in Japanese patients

Abstract: PDT was beneficial in the treatment of acne. As a photoactivating light source, polychromatic visible light was thought to be better for use with acne patients than laser light because of its cost-effectiveness, uniform illumination and time-efficiency in treating large areas.

Cited by 196 publications

References 14 publications

Photodynamic Therapy and Skin Appendage Disorders: A Review

Photodynamic Therapy and Skin Appendage Disorders: A Review

Photodynamic therapy in the treatment of microbial infections: Basic principles and perspective applications

Topical ALA-Photodynamic Therapy for Acne Can Induce Apoptosis of Sebocytes and Down-regulate Their TLR-2 and TLR-4 Expression

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