Photodermatology, photoimmunology & photomedicine最新文献

Background: Afamelanotide 16 mg (SCENESSE) is the first approved treatment for erythropoietic protoporphyria (EPP). EPP is a rare autosomal recessive inherited disorder of the haem biosynthesis pathway, where patients experience severe and debilitating acute phototoxicity. It affects at least one in 140,000 of the European population. A postauthorisation safety study (PASS) and a disease registry were imposed as conditions of the European marketing authorisation.

Objectives: Evaluate the short- and long-term safety and clinical effectiveness of afamelanotide 16 mg in EPP patients enrolled in the PASS in Germany.

Methods: The PASS (EUPAS13004) is an ongoing observational study collecting safety and effectiveness variables from treated and untreated EPP patients in the European EPP Disease Registry. Patients (n = 200, none untreated) received afamelanotide according to the summary of product characteristics. Treatment-emergent adverse events were collected as safety variables. Clinical effectiveness was assessed with the EPP-QoL tool and through treatment continuity.

Results: The short- and long-term safety and benefit-risk profile of afamelanotide under real-world conditions is consistent with the positive safety profile seen in clinical trials. EPP patients reported a significant increase in QoL compared with baseline values (p < 0.0001) and 91.0% of patients who started treatment continue being treated. The safety profile of afamelanotide in patients over 70 years of age is consistent with the overall patient population.

Conclusions: Afamelanotide treatment was highly effective and associated with a higher QoL in EPP patients. The study shows a positive safety profile of afamelanotide, with the treatment providing an ongoing clinical benefit.

Background: Several widely used drugs have photosensitizing properties, and much research has been conducted to find associations between their use and the risk of developing cutaneous malignant melanoma (cM), basal cell carcinoma (BCC) or cutaneous squamous cell carcinoma (cSCC), often with conflicting results.

Objective: To assess whether the use of commonly prescribed photosensitizing drugs increases skin cancer risk.

Methods: Analyses were performed using a large cohort of women, with prospectively collected information on phenotypic traits and sun exposure. Comprehensive information on pharmaceutical treatments and skin cancer occurrence was obtained through national registries. Drugs with photosensitizing properties were grouped according to the Anatomical Therapeutic Chemical system in nine groups, and associations between the use of such drugs were investigated using multivariable Cox regression analysis. The number of retrieved daily doses was analyzed to test the dose-response relationship.

Results: Hormone replacement therapy significantly increased the risk of BCC (hazard ratio [HR] 1.24; 95% confidence interval [CI]: 1.11-1.39), cSCC (HR 1.23; 95% CI: 1.03-1.47) and cM (HR 1.31; 95% CI: 1.01-1.69), with estrogen driving this risk. There was a trend of increased risk of BCC and cM with higher doses of estrogen treatment. Subgroup analysis among those using diuretics showed that loop diuretics were associated with increased cSCC risk (HR 1.6; 95% CI: 1.3-2.0), including a positive association between risk and dose. Furthermore, increased risks of BCC (HR 1.25; 95% CI: 1.09-1.44) and cM (HR 1.41; 95% CI: 1.03-1.93) were associated with thiazide use. NSAIDs showed a possible curvilinear association to BCC and cSCC.

Conclusions: Estrogen treatment increased the risk of all investigated skin cancers. Among those using diuretics, loop diuretics increased the risk of cSCC, and thiazide use increased the risk of BCC. We suggest that physicians should advise female patients prescribed estrogen, thiazides, or loop diuretics to limit their sun exposure.

Introduction: Vitiligo is a depigmenting autoimmune disease. This study aimed to determine the minimal erythema dose (MED) of vitiligo-affected skin and normal skin among patients with skin phototype III, IV, and V.

Methods: A cross-sectional study was performed. MED was determined using a handheld device with wavelength of 311 nm. Vitiligo severity was measured using the Vitiligo Area Scoring Index (VASI) while disease activity was assessed by the Vitiligo Disease Activity (VIDA). Sun exposure was quantified by the Sun Exposure Index (SEI).

Results: A total of 36 patients (mean age of 49.06 ± 21.29 years old) participated with 12 patients from each skin phototype. MEDs of skin affected by vitiligo were 255 ± 120.3, 280 ± 93.4, and 525 ± 226.1 mJ/cm² for phototypes III, IV, and V respectively. The MEDs of unaffected skin were 465 ± 120.3, 580 ± 123.6, and 1150 ± 116.8 mJ/cm² for phototypes III, IV, and V respectively. The MEDs for skin affected by vitiligo were 45%, 52%, and 54% less than the MEDs of unaffected skin for phototypes III, IV, and V respectively. The differences in MEDs between vitiligo-affected skin and unaffected skin were significant for all skin phototypes (p < 0.001). MED of skin with vitiligo negatively correlated with vitiligo severity, r = -0.426, p = 0.01. There were no significant correlations between MED and VIDA, disease duration, or SEI.

Conclusion: MED of skin with vitiligo was much lower than unaffected skin, and MEDs between skin phototypes III, IV, and V differed despite similar depigmentation. MED was not influenced by vitiligo disease activity, duration, or sun exposure.

Background: The collagen receptor Endo180 participates in extracellular matrix remodeling by clearing the pericellular environment and recognizing and internalizing collagen degradation products. In photoaged skin, Endo180 expression in fibroblasts is decreased, and collagen fragments accumulate in the pericellular environment, leading to a decrease in type I collagen production and an increase in matrix metalloproteinase 1 production. This suggests that a decrease in Endo180 production may promote wrinkle formation by decreasing the dermal collagen fibril volume. Therefore, this study aimed to identify materials that promote Endo180 production in vitro and investigate whether promoting Endo180 production could prevent and improve wrinkles in vivo.

Methods: Endo180 gene expression and protein production in fibroblasts were evaluated after screening 71 natural extracts. The conditioned medium of UVB-irradiated keratinocytes and Endo180 production-promoting extract were added to fibroblasts, and Endo180 and type I collagen production were evaluated. In a double-blind, randomized, placebo-controlled study, a cream formulated with an Endo180 production-promoting extract or placebo was topically administered to each side of the face of 20 healthy women twice daily for 8 weeks.

Results: Screening results showed that 50 μg/mL of lemon balm (Melissa officinalis L.) leaf extract (MOLE) resulted in the highest levels of both Endo180 mRNA and protein at 178.1% and 127.4%, respectively. Its major component rosmarinic acid also promoted Endo180 production by 143.9% at a concentration of 20 μg/mL. MOLE at 200 μg/mL almost completely inhibited the decrease in Endo180 and type I collagen production in UVB-irradiated keratinocyte-conditioned medium. Furthermore, eye-corner wrinkles were reduced by treatment with the MOLE formulation compared to that in response to the placebo formulation.

Conclusions: MOLE may act as an antiwrinkle agent that inhibits the decline in collagen levels by promoting Endo180 production.

Background/Purpose Photobiomodulation (PBM) using light-emitting diodes (LEDs) benefits tissue regeneration and wound healing. However, evidence regarding the efficacy of LED for post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) is limited. The aim of this study was to explore the effect of medical LED (830 nm and 590 nm) in the prevention and treatment of PIE and PIH. Methods The in vivo PIE/PIH model was simplified to erythema and pigmentation reaction after acute UVB exposure. 308 nm LED light (225 or 270 mJ/cm²) was induced in vivo in the PIE/PIH model on the thigh of ten healthy subjects. Every subject received therapeutic and preventive irradiation (n = 10 in each group). 830 nm (60 J/cm²) and 590 nm LEDs (20 J/cm²) were irradiated, respectively. For therapeutic irradiation, the PIE/PIH model was induced on D1, and LEDs were irradiated on D0, 1, 3, 6 and 8. For preventive irradiation, LEDs were irradiated on D0, 1, 3, 6, and 8 and the PIE/PIH model was induced on D9. Erythema index (EI), melanin index (MI), transdermal water loss (TEWL), and C-Cube photography were measured during 10-day follow-up visits. Results For therapeutic irradiation, ΔEI and ΔMI in the 830 nm treatment group were significantly lower than in the control group (ΔEI: 9.30 vs. 11.52, p = 0.027; ΔMI: 7.79 vs. 9.25, p = 0.026). No significant difference was found between the 590 nm treatment group and the control group in ΔEI or ∆MI (p > 0.05). For preventive irradiation, ΔEI in the 830 nm prevention group and the 590 nm prevention group were both significantly lower than the control group (830 nm: 9.85 vs. 19.90, p = 0.001; 590 nm: 12.50 vs. 19.90, p = 0.008). No significant difference was found between the two prevention LED groups (p > 0.05). Conclusions Both 830 nm and 590 nm LEDs showed preventive effects for PIE, and 830 nm LEDs could effectively improve PIE and PIH.

Background: Topical photodynamic therapy (PDT) is widely used in dermatology for treating superficial non-melanoma skin cancer (NMSC) and dysplasia. This study aims to assess real-world outcomes of PDT in a Scottish dermatology service.

Methods: We retrospectively reviewed patients with superficial NMSC and dysplasia who underwent conventional and daylight PDT at the Photobiology Unit, Dundee, Scotland.

Results: A total of 705 patients with 2108 NMSC and precancerous skin lesions underwent conventional PDT. Clearance at 12 months was achieved in 53.4% of actinic keratoses (AK), 71.3% of Bowenoid AK, 86.4% of Bowen's disease (BD), 89.0% of superficial basal cell carcinoma (BCC), and 89.7% of nodular BCC. On multivariate analysis, small lesion size and thin histological tumour thickness of superficial BCC were features, which were associated with likelihood of achieving clearance after PDT. Female sex, head/neck sites, larger lesion size, strong pre-treatment fluorescence intensity, fluorescence specificity, prominent treatment-induced erythema and an urticarial reaction were associated with moderate to severe pain during PDT. Daylight PDT for 77 AK patients (158 treatments) showed excellent or good outcomes in 63.3% of lesions. Higher visible light exposure is correlated with better treatment outcomes.

Conclusions: In real-life settings, whilst the PDT response rates of BD and selected BCC are high and consistent with clinical trial outcomes, the efficacy rates for AK appear lower than expected. This emphasizes the need for realistic expectations in chronic disease management. Through review over a prolonged period, factors associated with PDT tolerability and outcomes were identified, allowing predictive utilisation for optimizing patient-centred PDT regimens.

Objective: Exosomes (Exos) from adipose derived stem cells (ADSCs) can delay skin photoaging, but their effects on reactive oxygen species (ROS) remains unclear. This study aimed to investigate the relationship between adipose derived stem cell exosomes (ADSCs-Exos) in anti-photoaging of skin and glutathione (GSH)/ ROS expression in human fibroblasts.

Methods: A skin photoaging model was established by irradiating human fibroblasts with ultraviolet B (UVB) light in vitro. Next, exosomes from ADSCs were isolated for treating the photoaged fibroblasts. Afterwards, the alterations in photoaged fibroblasts were analyzed by a series of assays including senescence-associated β-galactosidase (SA-β-Gal) staining, p16 expression, ROS staining, and GSH content.

Results: After a human fibroblast photoaging model was subjected to ADSCs-Exos treatment, we found that the high concentration exosome group had the highest GSH content. Cellular staining showed that levels of SA-β-Gal, p16, and ROS of the high concentration-treated group were lower than other groups.

Conclusions: ADSCs-Exos can protect skin fibroblasts from photoaging via increasing the ratio of GSH/ROS.