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PEER-REVIEW | DERMATOLOGY |


COVER STORY


MANAGEMENT ACNE


PHOTODYNAMIC THERAPY FOR


Christopher Tzermias and Leonardo Marini discuss the findings of their study on the use of photometry-guided PDT with methyl- aminolevulinate activated by blue and red light for moderate-to-severe acne


ABSTRACT


This single clinical site retrospective study was performed to assess the effectiveness, safety, and tolerability of an innovative sequential multi- step dual wavelength LED (415 nm–633 nm) PDT using topical methyl-aminolevulinate (MAL) as a porphyrin precursor in controlling papulo-pustular and cystic acne in a population of 39 patients. Rationale: To study the clinical efficacy of an alternative treatment option to control moderate- to-severe acne suitable for individuals who cannot or do not want to take oral medications. Methods: After an initial dermatological evaluation of acne severity, MAL (Metvix 160mg/g) was uniformly applied over affected anatomical areas (occlusive contact time — OCT: 1 hour for facial regions, 2 hours for trunk sites). Photodynamic effect was generated by a sequential irradiation of one session of non-coherent blue LED (415nm) and two sessions of red LED (633nm) spaced by 20 minute intervals


(SBRR-LED-PDT). Superficial skin fluorescence (SSF) was assessed using a hand-held digital fluorimeter (Fluoderm, Dia-Medico Aps, Denmark) in order to monitor the rate of photo-bleaching before and immediately after LED irradiations.


Results: Acne severity score was found clinically decreased after SBRR-LED-PDT on all treated anatomical sites (p<.001). Superficial skin fluorescence (SSF) was found significantly increased at the end of each OCT, returning to pre-treatment baseline levels after sequential PDT photo-bleaching (p<.001).


Conclusion: SSF-controlled SBRR-LED-PDT can be considered as an effective alternative strategy to induce significant clinical remission of moderate- to-severe inflammatory acne affecting different anatomical areas, and could be proposed as a valid alternative to conventional oral medications.


CHRISTOPHER TZERMIAS, MD, Dermatology Practice 49, Vas. Sofias Avenue, 10676, Athens, Greece; LEONARDO MARINI, MD, The Skin Doctors Center Via Bonomo 5/a, Trieste 34126, Italy


email: ctzermias@gmail.


KEYWORDS Acne, blue/red LED photo-bleaching, methyl-aminolevulinate (MAL), PDT


22  August/September 2015 | prime-journal.com


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