Pub Date : 2023-11-01Epub Date: 2023-07-11DOI: 10.1111/phpp.12899
Luke Horton, Joshua Brady, Colin M Kincaid, Angeli Eloise Torres, Henry W Lim
Background: Infrared radiation (IR) is the portion of the electromagnetic spectrum between visible light (VL) and microwaves, with wavelengths between 700 nm and 1 mm. Humans are mainly exposed to ultraviolet (UV) radiation (UVR) and IR through the sun. Unlike UVR which is well known for its carcinogenic properties, the relationship between IR and skin health has not been as extensively studied; as such, we gather the available published evidence here to better elucidate this relationship.
Methods: Several databases including Pubmed, Google Scholar, and Embase were searched for articles relating to infrared radiation and the skin. Articles were selected for their relevance and novelty.
Results: Detrimental effects such as thermal burns, photocarcinogenesis, and photoaging have been reported, though evidence suggests that these may be due to the thermal effects produced secondary to IR exposure rather than the isolated effect of IR. There are currently no chemical or physical filters specifically available for protection against IR, and existing compounds are not known to have IR-filtering capacity. Interestingly, IR may have some photoprotective properties against the carcinogenic effects of UVR. Furthermore, IR has been used with encouraging results in skin rejuvenation, wound healing, and hair restoration when given at an appropriate therapeutic dose.
Conclusion: A better understanding of the current landscape of research surrounding IR can help illuminate its effects on the skin and highlight areas for further research. Here, we review relevant data on IR to assess its deleterious and beneficial effects on human skin, along with possible means for IR photoprotection.
{"title":"The effects of infrared radiation on the human skin.","authors":"Luke Horton, Joshua Brady, Colin M Kincaid, Angeli Eloise Torres, Henry W Lim","doi":"10.1111/phpp.12899","DOIUrl":"10.1111/phpp.12899","url":null,"abstract":"<p><strong>Background: </strong>Infrared radiation (IR) is the portion of the electromagnetic spectrum between visible light (VL) and microwaves, with wavelengths between 700 nm and 1 mm. Humans are mainly exposed to ultraviolet (UV) radiation (UVR) and IR through the sun. Unlike UVR which is well known for its carcinogenic properties, the relationship between IR and skin health has not been as extensively studied; as such, we gather the available published evidence here to better elucidate this relationship.</p><p><strong>Methods: </strong>Several databases including Pubmed, Google Scholar, and Embase were searched for articles relating to infrared radiation and the skin. Articles were selected for their relevance and novelty.</p><p><strong>Results: </strong>Detrimental effects such as thermal burns, photocarcinogenesis, and photoaging have been reported, though evidence suggests that these may be due to the thermal effects produced secondary to IR exposure rather than the isolated effect of IR. There are currently no chemical or physical filters specifically available for protection against IR, and existing compounds are not known to have IR-filtering capacity. Interestingly, IR may have some photoprotective properties against the carcinogenic effects of UVR. Furthermore, IR has been used with encouraging results in skin rejuvenation, wound healing, and hair restoration when given at an appropriate therapeutic dose.</p><p><strong>Conclusion: </strong>A better understanding of the current landscape of research surrounding IR can help illuminate its effects on the skin and highlight areas for further research. Here, we review relevant data on IR to assess its deleterious and beneficial effects on human skin, along with possible means for IR photoprotection.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-04-19DOI: 10.1111/phpp.12875
Qin Chen, Ling Li, Zhi-Qiang Song, Lan Ge
Dear editors, Acne vulgaris is a common skin disease of showing alteration of the keratinization process causing the progression from comedone formation to inflammatory response.1 Generally, acne vulgaris clinically responds well to the treatments such as salicylic acid, antibiotics, and/or combination with isotretinoin. However, in some individuals, acne vulgaris does not response to topical treatments or oral pharmacological interventions.2 Thus, these individuals with treatmentresistant acne vulgaris, socalled refractory acne vulgaris (RAV), require alternative options for the effective treatment. A 22yearold male patient presented to our dermatology outpatient unit with a 4year history of bilaterally facial acne vulgaris. Clinical examination showed a large number of comedones fused into one piece with inflammatory lesions on his faces (Figure 1A). The patient reported no respond to the treatment with oral isotretinoin (0.5 mg/kg/day). Therefore, the combinations of oral isotretinoin (0.5 mg/kg/day) and topical 30% salicylic acid (six times, one time per 2– 3 weeks) or alpha hydroxyl acid with adapalene gel as well as clindamycin hydrochloride and metronidazole liniments were initially used to treat the patient. After 3 months, the numbers of inflammatory lesions were slightly decreased. However, the patient reported a recurrence of superficial acne, and no alteration of the deep acne was observed (Figure 1B). Given an unsuccessful treatment with mediations, CO2 laser therapy was subsequently selected as an alternative treatment following the patient stopped taking medications for 2 weeks. The patient was treated with an ablative 10,600 nm fractional CO2 laser systems (Chongqing Jingyu Laser Technology Co., Ltd). Meanwhile, needle acupuncture was used to extrude fat plugs following CO2 laser therapy. After 2 months, the large facial acne still existed, though part of the comedones disappeared, and decreased numbers of inflammatory lesions were also observed (Figure 1C). Due to previous unsatisfactory curative effect, CO2 laser combined with 5aminolaevulinic acid photodynamic therapy (ALAPDT) were further performed. The treatment process showed as follows: CO2 laser described as above was used to vaporize the tip of comedones to form small pores, and the fat plugs were extruded by using needle acupuncture. Topical 5% ALA was immediately applied, and sterile cottons soaked with 5% ALA were covered bilaterally facial surface for 2 h. Then, Light irradiation was carried out by exposing the bilaterally facial surface to a red LED device (640 nm, Shenzhen Pumen Technology Co., Ltd) at the dose level of 72 mw/cm2 for 20 min, followed by cooling with ice for 2 h. The treatment was performed every 2 weeks. After 3 times of treatment, the facial acne was significantly improved with few inflammatory lesions and some scattered erythema and sunken acne pits (Figure 1D). The halfyear followup medical examinations showed only some sunken acne pits and no re
{"title":"CO<sub>2</sub> laser combined with ALA-PDT for successful treatment of refractory acne vulgaris: A case report.","authors":"Qin Chen, Ling Li, Zhi-Qiang Song, Lan Ge","doi":"10.1111/phpp.12875","DOIUrl":"10.1111/phpp.12875","url":null,"abstract":"Dear editors, Acne vulgaris is a common skin disease of showing alteration of the keratinization process causing the progression from comedone formation to inflammatory response.1 Generally, acne vulgaris clinically responds well to the treatments such as salicylic acid, antibiotics, and/or combination with isotretinoin. However, in some individuals, acne vulgaris does not response to topical treatments or oral pharmacological interventions.2 Thus, these individuals with treatmentresistant acne vulgaris, socalled refractory acne vulgaris (RAV), require alternative options for the effective treatment. A 22yearold male patient presented to our dermatology outpatient unit with a 4year history of bilaterally facial acne vulgaris. Clinical examination showed a large number of comedones fused into one piece with inflammatory lesions on his faces (Figure 1A). The patient reported no respond to the treatment with oral isotretinoin (0.5 mg/kg/day). Therefore, the combinations of oral isotretinoin (0.5 mg/kg/day) and topical 30% salicylic acid (six times, one time per 2– 3 weeks) or alpha hydroxyl acid with adapalene gel as well as clindamycin hydrochloride and metronidazole liniments were initially used to treat the patient. After 3 months, the numbers of inflammatory lesions were slightly decreased. However, the patient reported a recurrence of superficial acne, and no alteration of the deep acne was observed (Figure 1B). Given an unsuccessful treatment with mediations, CO2 laser therapy was subsequently selected as an alternative treatment following the patient stopped taking medications for 2 weeks. The patient was treated with an ablative 10,600 nm fractional CO2 laser systems (Chongqing Jingyu Laser Technology Co., Ltd). Meanwhile, needle acupuncture was used to extrude fat plugs following CO2 laser therapy. After 2 months, the large facial acne still existed, though part of the comedones disappeared, and decreased numbers of inflammatory lesions were also observed (Figure 1C). Due to previous unsatisfactory curative effect, CO2 laser combined with 5aminolaevulinic acid photodynamic therapy (ALAPDT) were further performed. The treatment process showed as follows: CO2 laser described as above was used to vaporize the tip of comedones to form small pores, and the fat plugs were extruded by using needle acupuncture. Topical 5% ALA was immediately applied, and sterile cottons soaked with 5% ALA were covered bilaterally facial surface for 2 h. Then, Light irradiation was carried out by exposing the bilaterally facial surface to a red LED device (640 nm, Shenzhen Pumen Technology Co., Ltd) at the dose level of 72 mw/cm2 for 20 min, followed by cooling with ice for 2 h. The treatment was performed every 2 weeks. After 3 times of treatment, the facial acne was significantly improved with few inflammatory lesions and some scattered erythema and sunken acne pits (Figure 1D). The halfyear followup medical examinations showed only some sunken acne pits and no re","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10271266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiajie Chen, Yu Gui, Sun Wang, Dawei Huang, Jiajie Lyu, Hui Cheng, Yantao Ding, Huabing Zhang, Shengxiu Liu
Background: Hemoporfin-mediated photodynamic therapy (HMME-PDT) is currently considered one of the most promising therapies for port-wine stain (PWS). However, the efficacy of this is very variable and needs further studies.
Methods: A total of 101 patients with PWS in the face, neck, or extremities who received at least 2 HMME-PDT sessions were included in the study, and correlations of efficacy with age, gender, locations, treatment sessions, and PDL treatment history were analyzed.
Results: The efficacy of HMME-PDT in patients with different ages, locations, and different numbers of prior PDL treatment showed constantly significant differences after 1/2/last session (p < .05). The number of treatments was associated with efficacy, and patients who received more than two sessions had a better response than those who underwent two sessions only (p < .001). Ordinal logistic regression analysis confirmed the above-mentioned associations. Nevertheless, patients of different sex, subtype, and lesion size showed no significant differences.
Conclusions: Our studies demonstrated that HMME-PDT is effective in the treatment of PWS. The more prior PDL treatments, older age, lips involvement, PWS on limbs were adverse factors for Hemoporfin-PDT, while multiple HMME-PDT sessions can improve effective and response rate. Besides, ambient temperature and lesions temperature should be concerned, local cooling provides some relief from pain but may influence effect.
{"title":"Analysis of related factors affecting hemoporfin-mediated photodynamic therapy for port-wine stain: A retrospective study.","authors":"Jiajie Chen, Yu Gui, Sun Wang, Dawei Huang, Jiajie Lyu, Hui Cheng, Yantao Ding, Huabing Zhang, Shengxiu Liu","doi":"10.1111/phpp.12874","DOIUrl":"https://doi.org/10.1111/phpp.12874","url":null,"abstract":"<p><strong>Background: </strong>Hemoporfin-mediated photodynamic therapy (HMME-PDT) is currently considered one of the most promising therapies for port-wine stain (PWS). However, the efficacy of this is very variable and needs further studies.</p><p><strong>Methods: </strong>A total of 101 patients with PWS in the face, neck, or extremities who received at least 2 HMME-PDT sessions were included in the study, and correlations of efficacy with age, gender, locations, treatment sessions, and PDL treatment history were analyzed.</p><p><strong>Results: </strong>The efficacy of HMME-PDT in patients with different ages, locations, and different numbers of prior PDL treatment showed constantly significant differences after 1/2/last session (p < .05). The number of treatments was associated with efficacy, and patients who received more than two sessions had a better response than those who underwent two sessions only (p < .001). Ordinal logistic regression analysis confirmed the above-mentioned associations. Nevertheless, patients of different sex, subtype, and lesion size showed no significant differences.</p><p><strong>Conclusions: </strong>Our studies demonstrated that HMME-PDT is effective in the treatment of PWS. The more prior PDL treatments, older age, lips involvement, PWS on limbs were adverse factors for Hemoporfin-PDT, while multiple HMME-PDT sessions can improve effective and response rate. Besides, ambient temperature and lesions temperature should be concerned, local cooling provides some relief from pain but may influence effect.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ting-Ting Yang, Ching-Wen Ma, Jyun-Wei Jhou, Yu-Ting Chen, Cheng-Che E Lan
Background: Identifying treatment responders after a single session of photo-based procedure for hyperpigmentary disorders may be difficult.
Objectives: We aim to train a convolutional neural network (CNN) to test the hypothesis that there exist discernible features in pretreatment photographs for identifying favorable responses after photo-based treatments for facial hyperpigmentation and develop a clinically applicable algorithm to predict treatment outcome.
Methods: Two hundred and sixty-four sets of pretreatment photographs of subjects receiving photo-based treatment for esthetic enhancement were obtained using the VISIA® skin analysis system. Preprocessing was done by masking the facial features of the photographs. Each set of photographs consists of five types of images. Five independently trained CNNs based on the Resnet50 backbone were developed based on these images and the results of these CNNs were combined to obtain the final result.
Results: The developed CNN algorithm has a prediction accuracy approaching 78.5% with area under the receiver operating characteristic curve being 0.839.
Conclusion: The treatment efficacy of photo-based therapies on facial skin pigmentation can be predicted based on pretreatment images.
{"title":"Response predictor for pigment reduction after one session of photo-based therapy using convolutional neural network: A proof of concept study.","authors":"Ting-Ting Yang, Ching-Wen Ma, Jyun-Wei Jhou, Yu-Ting Chen, Cheng-Che E Lan","doi":"10.1111/phpp.12891","DOIUrl":"https://doi.org/10.1111/phpp.12891","url":null,"abstract":"<p><strong>Background: </strong>Identifying treatment responders after a single session of photo-based procedure for hyperpigmentary disorders may be difficult.</p><p><strong>Objectives: </strong>We aim to train a convolutional neural network (CNN) to test the hypothesis that there exist discernible features in pretreatment photographs for identifying favorable responses after photo-based treatments for facial hyperpigmentation and develop a clinically applicable algorithm to predict treatment outcome.</p><p><strong>Methods: </strong>Two hundred and sixty-four sets of pretreatment photographs of subjects receiving photo-based treatment for esthetic enhancement were obtained using the VISIA® skin analysis system. Preprocessing was done by masking the facial features of the photographs. Each set of photographs consists of five types of images. Five independently trained CNNs based on the Resnet50 backbone were developed based on these images and the results of these CNNs were combined to obtain the final result.</p><p><strong>Results: </strong>The developed CNN algorithm has a prediction accuracy approaching 78.5% with area under the receiver operating characteristic curve being 0.839.</p><p><strong>Conclusion: </strong>The treatment efficacy of photo-based therapies on facial skin pigmentation can be predicted based on pretreatment images.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-06-16DOI: 10.1111/phpp.12894
Valeria Brazzelli, Grazia Bossi, Alice Bonelli, Eugenio Isoletta, Martina Volontè, Stefania Barruscotti, Mara De Amici, Elisa Bono, Jacqueline Ferrari, Emanuela Boveri
Dear editor, Mastocytosis encompasses a heterogeneous group of disorders characterized by pathological expansion and accumulation of clonal mast cells within one or more organs.1 According to the latest classification, three subtypes of the disease have been recognized based on the site and extent of organ involvement and dysfunction: cutaneous mastocytosis (CM), systemic mastocytosis (SM), and mast cell sarcoma (MCS).2,3 SM has been differentiated into nonadvanced and advanced forms, while the CM is divided into maculopapular CM (MPCM), diffuse CM (DCM), and mastocytoma subtypes.2,3 In pediatric age, mastocytosis is often limited to the skin (CM) and is considered to be a myeloproliferative clonal disease with benign course, outcome, and tendency to spontaneous resolution before puberty.4 Extracutaneous involvement in pediatric mastocytosis is relatively rare, most often presenting in the form of indolent systemic mastocytosis (ISM). Virtually all children with SM present with skin lesions, usually MPCM, accompanied by increased serum tryptase levels.4 Currently, the treatment of SM in pediatric patients lacks of standard guidelines: its primary aim is to limit the release of mediators of mast cell degranulation, by avoiding potential triggering factors. The mainstay of systemic therapy is secondgeneration H1 and H2 antihistamines, useful in decreasing flushing, pruritus, and controlling wheal formation.1,5 A valuable secondline therapy, proposed as an alternative approach for the treatment of refractory cases, is phototherapy.6 UVBNB phototherapy has been shown to be effective in many dermatological pediatric diseases associated with intense itch,7,8 and UVB light has been proven to have an inhibitory effect on mast cell degranulation, likely by causing noncytotoxic damage to the membrane phospholipid metabolism.9,10 Omalizumab has been successfully used to treat severe symptoms related to mastocytosis that are recalcitrant to conventional therapies,11 including cases of CM and ISM in pediatric patients,12 while in case of aggressive SM the clinician can consider the use of imatinib (if mast cells lack the cKIT D816V mutation) or other newer tyrosinekinase inhibitors.13 We report a case of a 13yearold girl, affected by ISM, who presented with cutaneous lesions since the sixth month of life, successfully treated with UVBNB phototherapy. The patient initially received a diagnosis of MPCM, and was referred to our Dermatologic Institute due to progressive worsening of her skin lesions during adolescence. At that time, she presented with several papules and erythematous, brown macules distributed on her face, arms, and trunk, and positivity for Darier's sign. Pruritus was one of the greatest causes of discomfort for the patient. The disfiguring appearance of the skin lesions was correlated with body image concerns, deeply affecting her quality of life (Figure 1). A progressive increase in the serum tryptase values was observed (from the baseline val
{"title":"A case of pediatric indolent systemic mastocytosis: The role of UVB-NB phototherapy in the treatment of cutaneous lesions.","authors":"Valeria Brazzelli, Grazia Bossi, Alice Bonelli, Eugenio Isoletta, Martina Volontè, Stefania Barruscotti, Mara De Amici, Elisa Bono, Jacqueline Ferrari, Emanuela Boveri","doi":"10.1111/phpp.12894","DOIUrl":"10.1111/phpp.12894","url":null,"abstract":"Dear editor, Mastocytosis encompasses a heterogeneous group of disorders characterized by pathological expansion and accumulation of clonal mast cells within one or more organs.1 According to the latest classification, three subtypes of the disease have been recognized based on the site and extent of organ involvement and dysfunction: cutaneous mastocytosis (CM), systemic mastocytosis (SM), and mast cell sarcoma (MCS).2,3 SM has been differentiated into nonadvanced and advanced forms, while the CM is divided into maculopapular CM (MPCM), diffuse CM (DCM), and mastocytoma subtypes.2,3 In pediatric age, mastocytosis is often limited to the skin (CM) and is considered to be a myeloproliferative clonal disease with benign course, outcome, and tendency to spontaneous resolution before puberty.4 Extracutaneous involvement in pediatric mastocytosis is relatively rare, most often presenting in the form of indolent systemic mastocytosis (ISM). Virtually all children with SM present with skin lesions, usually MPCM, accompanied by increased serum tryptase levels.4 Currently, the treatment of SM in pediatric patients lacks of standard guidelines: its primary aim is to limit the release of mediators of mast cell degranulation, by avoiding potential triggering factors. The mainstay of systemic therapy is secondgeneration H1 and H2 antihistamines, useful in decreasing flushing, pruritus, and controlling wheal formation.1,5 A valuable secondline therapy, proposed as an alternative approach for the treatment of refractory cases, is phototherapy.6 UVBNB phototherapy has been shown to be effective in many dermatological pediatric diseases associated with intense itch,7,8 and UVB light has been proven to have an inhibitory effect on mast cell degranulation, likely by causing noncytotoxic damage to the membrane phospholipid metabolism.9,10 Omalizumab has been successfully used to treat severe symptoms related to mastocytosis that are recalcitrant to conventional therapies,11 including cases of CM and ISM in pediatric patients,12 while in case of aggressive SM the clinician can consider the use of imatinib (if mast cells lack the cKIT D816V mutation) or other newer tyrosinekinase inhibitors.13 We report a case of a 13yearold girl, affected by ISM, who presented with cutaneous lesions since the sixth month of life, successfully treated with UVBNB phototherapy. The patient initially received a diagnosis of MPCM, and was referred to our Dermatologic Institute due to progressive worsening of her skin lesions during adolescence. At that time, she presented with several papules and erythematous, brown macules distributed on her face, arms, and trunk, and positivity for Darier's sign. Pruritus was one of the greatest causes of discomfort for the patient. The disfiguring appearance of the skin lesions was correlated with body image concerns, deeply affecting her quality of life (Figure 1). A progressive increase in the serum tryptase values was observed (from the baseline val","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10272275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lioudmila Tchvialeva, Jamie Phillips, Daniel C Louie, Haishan Zeng, Harvey Lui, Tim K Lee
Background/purpose: A recent direction in skin disease classification is to develop quantitative diagnostic techniques. Skin relief, colloquially known as roughness, is an important clinical feature. The aim of this study is to demonstrate a novel polarization speckle technique to quantitatively measure roughness on skin lesions in vivo. We then calculate the average roughness of different types of skin lesions to determine the extent to which polarization speckle roughness measurements can be used to identify skin cancer.
Methods: The experimental conditions were set to target the fine relief structure on the order of ten microns within a small field of view of 3 mm. The device was tested in a clinical study on patients with malignant and benign skin lesions that resemble cancer. The cancer group includes 37 malignant melanomas (MM), 43 basal cell carcinomas (BCC), and 26 squamous cell carcinomas (SCC), all categories confirmed by gold standard biopsy. The benign group includes 109 seborrheic keratoses (SK), 79 nevi, and 11 actinic keratoses (AK). Normal skin roughness was obtained for the same patients (301 different body sites proximal to the lesion).
Results: The average root mean squared (rms) roughness ± standard error of the mean for MM and nevus was equal to 19 ± 5 μm and 21 ± 3 μm, respectively. Normal skin has rms roughness of 31 ± 3 μm, other lesions have roughness of 35 ± 10 μm (AK), 35 ± 7 μm (SCC), 31 ± 4 μm (SK), and 30 ± 5 μm (BCC).
Conclusion: An independent-samples Kruskal-Wallis test indicates that MM and nevus can be separated from each of the tested types of lesions, except each other. These results quantify clinical knowledge of lesion roughness and could be useful for optical cancer detection.
{"title":"Micro-relief characterization of benign and malignant skin lesions by polarization speckle analysis in vivo.","authors":"Lioudmila Tchvialeva, Jamie Phillips, Daniel C Louie, Haishan Zeng, Harvey Lui, Tim K Lee","doi":"10.1111/phpp.12876","DOIUrl":"https://doi.org/10.1111/phpp.12876","url":null,"abstract":"<p><strong>Background/purpose: </strong>A recent direction in skin disease classification is to develop quantitative diagnostic techniques. Skin relief, colloquially known as roughness, is an important clinical feature. The aim of this study is to demonstrate a novel polarization speckle technique to quantitatively measure roughness on skin lesions in vivo. We then calculate the average roughness of different types of skin lesions to determine the extent to which polarization speckle roughness measurements can be used to identify skin cancer.</p><p><strong>Methods: </strong>The experimental conditions were set to target the fine relief structure on the order of ten microns within a small field of view of 3 mm. The device was tested in a clinical study on patients with malignant and benign skin lesions that resemble cancer. The cancer group includes 37 malignant melanomas (MM), 43 basal cell carcinomas (BCC), and 26 squamous cell carcinomas (SCC), all categories confirmed by gold standard biopsy. The benign group includes 109 seborrheic keratoses (SK), 79 nevi, and 11 actinic keratoses (AK). Normal skin roughness was obtained for the same patients (301 different body sites proximal to the lesion).</p><p><strong>Results: </strong>The average root mean squared (rms) roughness ± standard error of the mean for MM and nevus was equal to 19 ± 5 μm and 21 ± 3 μm, respectively. Normal skin has rms roughness of 31 ± 3 μm, other lesions have roughness of 35 ± 10 μm (AK), 35 ± 7 μm (SCC), 31 ± 4 μm (SK), and 30 ± 5 μm (BCC).</p><p><strong>Conclusion: </strong>An independent-samples Kruskal-Wallis test indicates that MM and nevus can be separated from each of the tested types of lesions, except each other. These results quantify clinical knowledge of lesion roughness and could be useful for optical cancer detection.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chryssoula Papageorgiou, Elizabeth Lazaridou, Konstantinos Lallas, Kyparissos Papaioannou, Vasiliki Nikolaou, Valeria Mateeva, Konstantinos Efthymiadis, Chrysanthi Koukoutzeli, Konstantia Loga, Eleni Sogka, Evangelos Karamitrousis, George Lazaridis, Dimitrios Dionysopoulos, Aimilios Lallas, Christina Kemanetzi, Christina Fotiadou, Eleni Timotheadou, Zoe Apalla
Background: Limited data on immune checkpoint inhibitor (ICI)-induced pruritus per se and efficacy of different therapeutic modalities in its management exist.
Objective: To study the quantitative and qualitative characteristics of ICI-induced pruritus per se and to assess the efficacy of the therapeutic modalities usually applied.
Methods: We retrospectively reviewed the records of 91 patients who were under treatment with ICIs for any kind of neoplasia and developed pruritus during treatment.
Results: Twenty out of 91 individuals (22.0%) with ICI-induced pruritus had pruritus as the only symptom, while 71/91 (78.0%) presented with pruritus coexisting with an additional cutaneous toxicity. Pruritus was treated with antihistamines (18/20, 90.0%) and/or topical regimens, as first-line choice. In resistant cases, as a second therapeutic intervention, narrow-band UVB (NBUVB), oral steroids and GABA analogs were added (70.0%). Statistical analysis revealed a significant difference in mean pruritus Numerical Rating Scale (NRS) scores between baseline and sequential visits. Moreover, subgroup analysis revealed a significant reduction in mean NRS scores in those treated with phototherapy.
Limitations: Retrospective design, low number of patients and survivorship bias.
Conclusion: Pruritus per se was present in a substantial portion of our cohort (22.0%). Our study confirms the efficacy of current treatment strategies and suggests NBUVB as a potential steroid-sparing therapeutic alternative.
{"title":"A retrospective multicentric cohort study of checkpoint inhibitors-induced pruritus with focus on management.","authors":"Chryssoula Papageorgiou, Elizabeth Lazaridou, Konstantinos Lallas, Kyparissos Papaioannou, Vasiliki Nikolaou, Valeria Mateeva, Konstantinos Efthymiadis, Chrysanthi Koukoutzeli, Konstantia Loga, Eleni Sogka, Evangelos Karamitrousis, George Lazaridis, Dimitrios Dionysopoulos, Aimilios Lallas, Christina Kemanetzi, Christina Fotiadou, Eleni Timotheadou, Zoe Apalla","doi":"10.1111/phpp.12892","DOIUrl":"https://doi.org/10.1111/phpp.12892","url":null,"abstract":"<p><strong>Background: </strong>Limited data on immune checkpoint inhibitor (ICI)-induced pruritus per se and efficacy of different therapeutic modalities in its management exist.</p><p><strong>Objective: </strong>To study the quantitative and qualitative characteristics of ICI-induced pruritus per se and to assess the efficacy of the therapeutic modalities usually applied.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of 91 patients who were under treatment with ICIs for any kind of neoplasia and developed pruritus during treatment.</p><p><strong>Results: </strong>Twenty out of 91 individuals (22.0%) with ICI-induced pruritus had pruritus as the only symptom, while 71/91 (78.0%) presented with pruritus coexisting with an additional cutaneous toxicity. Pruritus was treated with antihistamines (18/20, 90.0%) and/or topical regimens, as first-line choice. In resistant cases, as a second therapeutic intervention, narrow-band UVB (NBUVB), oral steroids and GABA analogs were added (70.0%). Statistical analysis revealed a significant difference in mean pruritus Numerical Rating Scale (NRS) scores between baseline and sequential visits. Moreover, subgroup analysis revealed a significant reduction in mean NRS scores in those treated with phototherapy.</p><p><strong>Limitations: </strong>Retrospective design, low number of patients and survivorship bias.</p><p><strong>Conclusion: </strong>Pruritus per se was present in a substantial portion of our cohort (22.0%). Our study confirms the efficacy of current treatment strategies and suggests NBUVB as a potential steroid-sparing therapeutic alternative.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10627469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alba Navarro-Bielsa, Tamara Gracia-Cazaña, Manuel Almagro, Sonia De la Fuente-Meira, Ángeles Florez, Oriol Yélamos, Trinidad Montero-Vilchez, Carlos González-Cruz, Adrián Diago, Isabel Abadías-Granado, Victoria Fuentelsaz, María Colmenero, José Bañuls, Salvador Arias-Santiago, Agustín Buendía-Eisman, Manuel Almenara-Blasco, Pedro Gil-Pallares, Yolanda Gilaberte
Background: While skin cancer awareness programs have significantly furthered public understanding about the harmful effects of the sun, there is a disparity between photoprotection knowledge and protection practices.
Objective: To compare sun exposure habits and photoprotection measures in patients diagnosed with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma versus controls.
Methods: Multicentre case-control observational study carried out by 13 Spanish dermatologists between April 2020 and August 2022. Patients diagnosed with BCC, SCC, or melanoma were considered cases. The control group consisted of individuals with no history of skin cancer.
Results: Of the 254 cases (56.2% female; mean age, 62.67 ± 15.65), 119 (31.2%) had BCC, 62 (16.27%) SCC, and 73 (19.1%) melanoma. The control group consisted of 127 (33.33%) individuals. Avoiding sun exposure between 12:00 and 16:00 was the most commonly used photoprotection measure (habitually/always: 63.1%), followed by the use of sunscreen (habitually/always: 58.9%). Patients with melanoma were less likely to use clothing and shade to avoid sun exposure (p < .05), whereas those with BCC and SCC reported greater use of head coverings (p = .01). BCC and SCC groups reported greater sun exposure 15 years prior, whereas controls reported greater use of sunscreen. However, at the time of this study all groups reported using SPF ≥ 21, and the majority SPF > 50. No differences were observed in photoprotection measures between people with and without a previous history of skin cancer.
Conclusions: We describe differences in photoprotection measures and sun exposure patterns among patients diagnosed with different skin tumor types. Whether these differences may influence the type of tumor each developed will require further investigation.
{"title":"A multicenter case-control study comparing sun exposure habits and use of photoprotection measures in patients diagnosed with different types of skin cancer.","authors":"Alba Navarro-Bielsa, Tamara Gracia-Cazaña, Manuel Almagro, Sonia De la Fuente-Meira, Ángeles Florez, Oriol Yélamos, Trinidad Montero-Vilchez, Carlos González-Cruz, Adrián Diago, Isabel Abadías-Granado, Victoria Fuentelsaz, María Colmenero, José Bañuls, Salvador Arias-Santiago, Agustín Buendía-Eisman, Manuel Almenara-Blasco, Pedro Gil-Pallares, Yolanda Gilaberte","doi":"10.1111/phpp.12878","DOIUrl":"https://doi.org/10.1111/phpp.12878","url":null,"abstract":"<p><strong>Background: </strong>While skin cancer awareness programs have significantly furthered public understanding about the harmful effects of the sun, there is a disparity between photoprotection knowledge and protection practices.</p><p><strong>Objective: </strong>To compare sun exposure habits and photoprotection measures in patients diagnosed with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma versus controls.</p><p><strong>Methods: </strong>Multicentre case-control observational study carried out by 13 Spanish dermatologists between April 2020 and August 2022. Patients diagnosed with BCC, SCC, or melanoma were considered cases. The control group consisted of individuals with no history of skin cancer.</p><p><strong>Results: </strong>Of the 254 cases (56.2% female; mean age, 62.67 ± 15.65), 119 (31.2%) had BCC, 62 (16.27%) SCC, and 73 (19.1%) melanoma. The control group consisted of 127 (33.33%) individuals. Avoiding sun exposure between 12:00 and 16:00 was the most commonly used photoprotection measure (habitually/always: 63.1%), followed by the use of sunscreen (habitually/always: 58.9%). Patients with melanoma were less likely to use clothing and shade to avoid sun exposure (p < .05), whereas those with BCC and SCC reported greater use of head coverings (p = .01). BCC and SCC groups reported greater sun exposure 15 years prior, whereas controls reported greater use of sunscreen. However, at the time of this study all groups reported using SPF ≥ 21, and the majority SPF > 50. No differences were observed in photoprotection measures between people with and without a previous history of skin cancer.</p><p><strong>Conclusions: </strong>We describe differences in photoprotection measures and sun exposure patterns among patients diagnosed with different skin tumor types. Whether these differences may influence the type of tumor each developed will require further investigation.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10626900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-06-12DOI: 10.1111/phpp.12889
A Fityan, G A Aneju, A M S Morley, R Sarkany
Congenital erythropoietic porphyria (CEP) or Günthers disease is a rare hematological porphyria, which occurs due to an inherited reduction in activity of the uroporphyrinogen III synthase enzyme (UROS). This results in the accumulation of water soluble, type I isomer porphyrins in the skin.1 Exposure to violet light in the Soret waveband (roughly 400– 410 nm) leads to the development of blisters on exposed skin, scar formation and subsequent disfigurement. Uroporphyrins are also deposited in other body tissues including the eye. Exposure of the ocular surface to violet light leads to vesicle formation, scarring, and symblephara. Scleral damage includes both acute scleritis and slowly progressive scleral necrosis, and may be accompanied by corneal thinning, perforation, visual loss and significant morbidity.2,3 Early education regarding the importance of photoprotection for patients with CEP is vital to limit the development of irreversible ocular damage. Many sunglasses offer a high level of protection against UVA and UVB helping to prevent against chronic UV exposurerelated cataract and pterygium formation. However, the protection afforded by standard sunglasses is only guaranteed up to 380 nm in Europe (BS EN ISO 123121:2013) and thus offers patients with CEP little or no protection against ocular damage caused by porphyrinrelated, short wavelength, visible light.4 Despite this, patients with CEP rely on standard sunglasses or, in some instances, nothing at all, given that the orangetinted lenses that provide protection against short wavelength visible light are often considered cosmetically unacceptable. Such behavior puts patients at risk of exposure to potentially damaging levels of visible light. In recent years, there has been increasing public awareness of the negative impact of exposure to artificial blue light on sleep.5,6 This has led to the manufacture and marketing of blue light protecting glasses to protect the eyes against blue light from computer and mobile device screens (gaming glasses). In view of these potentially useful properties for patients with porphyria, we undertook a small study to assess the wavelength of light blocked by these lenses to determine whether the protection might be sufficient to recommend their use in CEP. Seven different pairs of gaming spectacles were randomly selected and purchased online via Amazon UK marketplace (Table 1). The optical transmission characteristics of all lenses were measured using a DMC150 Bentham spectroradiometer (Bentham Instruments) in a radiation beam from an Abet 2000 Solar Simulator (Abet Technologies, Inc) in the ultraviolet and near visible region from 250 to 500 nm. Comparison of the transmitted spectrum of each lens with that of the unfiltered monochromator was used to derive the lens transmission.7 Of the seven spectacles (G1– G7) tested, five reduced transmission within the CEP spectral band (400– 415 nm) by more than 94% and six by more than 87%. Two pairs of glasses,
{"title":"Ocular protection in congenital erythropoietic porphyria: A potential role for gaming glasses.","authors":"A Fityan, G A Aneju, A M S Morley, R Sarkany","doi":"10.1111/phpp.12889","DOIUrl":"10.1111/phpp.12889","url":null,"abstract":"Congenital erythropoietic porphyria (CEP) or Günthers disease is a rare hematological porphyria, which occurs due to an inherited reduction in activity of the uroporphyrinogen III synthase enzyme (UROS). This results in the accumulation of water soluble, type I isomer porphyrins in the skin.1 Exposure to violet light in the Soret waveband (roughly 400– 410 nm) leads to the development of blisters on exposed skin, scar formation and subsequent disfigurement. Uroporphyrins are also deposited in other body tissues including the eye. Exposure of the ocular surface to violet light leads to vesicle formation, scarring, and symblephara. Scleral damage includes both acute scleritis and slowly progressive scleral necrosis, and may be accompanied by corneal thinning, perforation, visual loss and significant morbidity.2,3 Early education regarding the importance of photoprotection for patients with CEP is vital to limit the development of irreversible ocular damage. Many sunglasses offer a high level of protection against UVA and UVB helping to prevent against chronic UV exposurerelated cataract and pterygium formation. However, the protection afforded by standard sunglasses is only guaranteed up to 380 nm in Europe (BS EN ISO 123121:2013) and thus offers patients with CEP little or no protection against ocular damage caused by porphyrinrelated, short wavelength, visible light.4 Despite this, patients with CEP rely on standard sunglasses or, in some instances, nothing at all, given that the orangetinted lenses that provide protection against short wavelength visible light are often considered cosmetically unacceptable. Such behavior puts patients at risk of exposure to potentially damaging levels of visible light. In recent years, there has been increasing public awareness of the negative impact of exposure to artificial blue light on sleep.5,6 This has led to the manufacture and marketing of blue light protecting glasses to protect the eyes against blue light from computer and mobile device screens (gaming glasses). In view of these potentially useful properties for patients with porphyria, we undertook a small study to assess the wavelength of light blocked by these lenses to determine whether the protection might be sufficient to recommend their use in CEP. Seven different pairs of gaming spectacles were randomly selected and purchased online via Amazon UK marketplace (Table 1). The optical transmission characteristics of all lenses were measured using a DMC150 Bentham spectroradiometer (Bentham Instruments) in a radiation beam from an Abet 2000 Solar Simulator (Abet Technologies, Inc) in the ultraviolet and near visible region from 250 to 500 nm. Comparison of the transmitted spectrum of each lens with that of the unfiltered monochromator was used to derive the lens transmission.7 Of the seven spectacles (G1– G7) tested, five reduced transmission within the CEP spectral band (400– 415 nm) by more than 94% and six by more than 87%. Two pairs of glasses, ","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}