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Wang Q, Gan Z, Wang X, Li X, Zhao L, Li D, Xu Z, Mu C, Ge L, Li D. Dissolving Hyaluronic Acid-Based Microneedles to Transdermally Deliver Eugenol Combined with Photothermal Therapy for Acne Vulgaris Treatment. ACS APPLIED MATERIALS & INTERFACES 2024; 16:21595-21609. [PMID: 38635857 DOI: 10.1021/acsami.4c01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
A microneedle transdermal drug delivery system simultaneously avoids systemic toxicity of oral administration and low efficiency of traditional transdermal administration, which is of great significance for acne vulgaris therapy. Herein, eugenol-loaded hyaluronic acid-based dissolving microneedles (E@P-EO-HA MNs) with antibacterial and anti-inflammatory activities are developed for acne vulgaris therapy via eugenol transdermal delivery integrated with photothermal therapy. E@P-EO-HA MNs are pyramid-shaped with a sharp tip and a hollow cavity structure, which possess sufficient mechanical strength to penetrate the stratum corneum of the skin and achieve transdermal delivery, in addition to excellent in vivo biocompatibility. Significantly, E@P-EO-HA MNs show effective photothermal therapy to destroy sebaceous glands and achieve antibacterial activity against deep-seated Propionibacterium acnes (P. acnes) under near-infrared-light irradiation. Moreover, cavity-loaded eugenol is released from rapidly dissolved microneedle bodies to play a sustained antibacterial and anti-inflammatory therapy on the P. acnes infectious wound. E@P-EO-HA MNs based on a synergistic therapeutic strategy combining photothermal therapy and eugenol transdermal administration can significantly alleviate inflammatory response and ultimately facilitate the repair of acne vulgaris. Overall, E@P-EO-HA MNs are expected to be clinically applied as a functional minimally invasive transdermal delivery strategy for superficial skin diseases therapy in skin tissue engineering.
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Affiliation(s)
- Qi Wang
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Zhiyang Gan
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Xinxin Wang
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Xinying Li
- Key Laboratory of General Chemistry of the National Ethnic Affairs Commission, School of Chemistry and Environment, Southwest Minzu University, Chengdu 610041, P. R. China
| | - Lei Zhao
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Derong Li
- People's Hospital of Lanshan District, Linyi 27600, P. R. China
| | - Zhilang Xu
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Changdao Mu
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Liming Ge
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Defu Li
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
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Zhang X, Zhou M, Liu Y, Zeng R. Recent advances in the treatment of acne using radiofrequency techniques. Lasers Med Sci 2024; 39:92. [PMID: 38499897 DOI: 10.1007/s10103-024-04039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
Acne is a long-lasting inflammatory skin condition that impacts the sebaceous units of the hair follicles, affecting around 85-90% of the population. Due to the potential for permanent facial scarring and negative social consequences, as well as the limitations of conventional medications like drug resistance and difficulties following treatment plans, it's crucial to investigate non-pharmacological options for treating acne, among which radiofrequency(RF) shows distinct superiority. To assess the impact of RF in the management of acne vulgaris, we conducted a thorough examination of scientific literature (including clinical trials and scientific reviews) through electronic databases like MEDLINE and PubMed. Our analysis indicates that RF could be a viable substitute for acne treatment due to its notable effectiveness and minimal adverse effects.
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Affiliation(s)
- Xin Zhang
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China
| | - Meng Zhou
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China
| | - Yuzhen Liu
- Department of Dermatology, Nanjing Jiangning Hospital, Nanjing, 211100, Jiangsu, China.
| | - Rong Zeng
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No. 120 Guanghua Rd, Kunming, 650021, Yunnan, China.
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Park S, Jang H, Seong SH, Kim JY, Lee EJ, Bae YJ, Ahn YJ, Kim J, Oh SH. The effects of long-pulsed alexandrite laser therapy on facial redness and skin microbiota compositions in rosacea: A prospective, multicentre, single-arm clinical trial. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40. [PMID: 37890996 DOI: 10.1111/phpp.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/26/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and intense pulsed light treatments for rosacea have been demonstrated in several clinical trials. However, there is currently no research on the efficacy of long-pulsed alexandrite laser (LPAL) therapy alone for rosacea-related facial redness and its effect on skin microbiota. AIM To evaluate the efficacy of LPAL therapy on facial redness in rosacea and assess changes in skin microbiota composition. METHODS Subjects with rosacea (n = 21, mean age: 39.2 ± 11.3 years) were recruited from two medical institutions and received monthly LPAL treatments (Clarity II™, Lutronic Corp.) for 3 months. At each visit, clinical photographs were taken, and erythema was measured using a spectrometer. At the initial and final visits, the Dermatology Life Quality Index (DLQI) and Skin Sensitivity Questionnaire (SSQ) were evaluated. Skin swabs were obtained at the initial and final visit, and facial microbiome composition was analysed using 16S rRNA amplicon sequencing. RESULTS After three LPAL treatment sessions, the average facial erythema index, measured using Mexameter® decreased significantly from 360.0 ± 96.7 at baseline to 312.0 ± 94.5 at the final visit (p < .05). The DLQI and SSQ showed significant improvement of symptoms. Skin microbiome diversity and relative abundance were altered significantly, particularly in the genera Clostridium, Lawsonella, Bacteroides, and Lactobacillus. CONCLUSIONS LPAL therapy alone showed favourable efficacy for the treatment of facial redness in rosacea, with some impacts on the skin microbiota composition.
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Affiliation(s)
- Sujin Park
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunwoo Jang
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seol Hwa Seong
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Jeong Bae
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Ju Ahn
- HuNBiome Co., Ltd., R&D Center, Seoul, Korea
| | - Jihee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kim J, Lee SG, Choi S, Lee J, Lee YI, Kim J, Lee JH. Combination of Fractional Microneedling Radiofrequency and Ablative Fractional Laser versus Ablative Fractional Laser Alone for Acne and Acne Scars. Yonsei Med J 2023; 64:721-729. [PMID: 37992744 PMCID: PMC10681823 DOI: 10.3349/ymj.2023.0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE Fractional microneedle radiofrequency (FMR) systems are used to treat inflammatory acne and scarring. Nonetheless, few controlled studies have combined this treatment with the traditional ablative fractional laser (AFL). We aimed to assess the safety and efficacy of the combination of FMR and AFL versus AFL alone in treating acne and acne scars. MATERIALS AND METHODS In this 20-week, randomized, split-face study, 23 Korean patients with facial acne and acne scars underwent FMR and AFL treatments. One half of each patient's face was randomly assigned to receive FMR+AFL, whereas the other half received AFL alone. Treatments were administered in three consecutive sessions at 4-week intervals. This study investigated the severity of inflammatory acne, acne scars, individual lesion counts, depressed scar volumes, as well as patient and physician satisfaction. In addition, five patients underwent skin biopsy, and sebum output was measured. RESULTS The FMR+AFL treatment demonstrated superior efficacy compared to AFL alone in terms of inflammatory acne and acne scar grading, lesion counts, and subjective satisfaction. The side effects were minimal and well-tolerated in both groups. Immunohistochemical findings from skin biopsy samples revealed that the application of FMR+AFL could induce an inhibitory effect on sebum secretion at the molecular level. CONCLUSION FMR combined with AFL is a well-tolerated and effective treatment modality for inflammatory acne and acne scarring.
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Affiliation(s)
- Jemin Kim
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Gyu Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sooyeon Choi
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Joohee Lee
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young In Lee
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jihee Kim
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Hee Lee
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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Ergen SK, Subasi S, Rencber SF, Duruksu G, Yazir Y. Evaluation of clinical and histological effects of KGF-2 and NGF on corneal wound healing in an experimental alkali burn rabbit model. Exp Eye Res 2022; 223:109190. [PMID: 35963307 DOI: 10.1016/j.exer.2022.109190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/02/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022]
Abstract
Endogenously produced peptide growth factors such as keratinocyte growth factor-2 (KGF-2) and nerve growth factor (NGF) play a key role in the natural corneal wound healing process. However, this self-healing ability of the corneal tissue is often impaired in cases of severe corneal damage, as in corneal alkali injuries. In the present study, we investigated the clinical and histopathological effects of topical recombinant human keratinocyte growth factor-2 and nerve growth factor treatments in a rabbit model of corneal alkali burn. After induction of an alkali burn, 24 rabbits were divided equally into three groups: control group, KGF-2 group, and NGF group. Clinical parameters including epithelial healing, opacification, neovascularization and central corneal thickness were evaluated on the first (D1), seventh (D7) and fourteenth (D14) days after injury. Corneal histology was performed using hematoxylin/eosin (H&E) and Masson's Trichrome stains. Immunohistochemical staining for matrix metalloproteinase-2 (MMP-2), MMP-9 and transforming growth factor-β (TGF-β) was performed. On D14, the percentage of epithelial defect and opacity were significantly less in the KGF-2 and NGF groups compared to the control group (p < 0.05). There was no significant difference between the groups in central corneal thickness. In the evaluation of neovascularization on D14, the NGF group was significantly less vascularized than the control group (p = 0.011). Histological examination showed a significant increase in stromal edema and inflammation in the control group compared to both treatment groups (p < 0.05). There was also a significant difference between the NGF and control groups in histological evaluation of epithelial repair and vascularization (p < 0.05). When immunoreactivity of MMP-2, MMP-9 and TGF-β was examined, there was a significant increase in the control group compared to the NGF group (p < 0.05). Taken together, both NGF and KGF-2 treatments were effective for early re-epithelialization and decrease in inflammation, opacity and neovascularization after corneal alkali burn. The inhibitory effect of NGF treatment on chemical-induced neovascularization was found to be superior to KGF-2 treatment.
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Affiliation(s)
- Sebnem Kaya Ergen
- Department of Ophthalmology, Karamürsel State Hospital, Kocaeli, Turkey.
| | - Sevgi Subasi
- Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Selenay Furat Rencber
- Department of Histology and Embryology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Gökhan Duruksu
- Stem Cell and Gene Therapies Research and Applied Center, Kocaeli University, Kocaeli, Turkey
| | - Yusufhan Yazir
- Department of Histology and Embryology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey; Stem Cell and Gene Therapies Research and Applied Center, Kocaeli University, Kocaeli, Turkey
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Zdrada J, Stolecka-Warzecha A, Odrzywołek W, Deda A, Błońska-Fajfrowska B, Wilczyński S. The use of light in the treatment of acne vulgaris-a review. J Cosmet Dermatol 2021; 20:3788-3792. [PMID: 34674364 DOI: 10.1111/jocd.14506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022]
Abstract
Topical and oral antibiotic therapy is also a popular method of treatment. The effectiveness of this method is limited by the increasing resistance of bacteria to antibiotics. Over the decades since the introduction of antibiotics to treat acne, the resistance levels of bacteria have changed. This defense mechanism is developed evolutionarily. Modifications of antibiotic receptor sites, alteration of drug influx/efflux, or enzymatic degradation are common mechanisms used by bacteria to initiate and strengthen internal antibiotic resistance. The basic chromophores used in light therapy are hemoglobin, melanin, water bound to proteins, and porphyrins. Hemoglobin absorbs light mainly at 580 nm, while melanin absorbs the entire visible spectral range (400-750 nm). Porphyrins are aromatic compounds, classified as photosensitizing substances, intensively absorbing blue light, and to a lesser extent in long visible bands, such as orange and red light. Using IPL makes it possible to cover the maximum light absorption of porphyrins and hemoglobin, therefore it can be an effective tool in the treatment of inflammatory lesions in acne vulgaris. In view of the effectiveness of light therapy and its effect even on antibiotic-resistant bacteria, it is worth considering the possibility of using light therapy instead of antibiotic therapy. Due to the increasing resistance of bacteria to antimicrobials, they should be used with caution and as a last resort. The high-energy light treatment act only locally (unlike with antibiotics taken orally) and on a chromophore, such as melanin, hemoglobin, or porphyrins.
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Affiliation(s)
- Julita Zdrada
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Anna Stolecka-Warzecha
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Wiktoria Odrzywołek
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Anna Deda
- Department of Cosmetology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Barbara Błońska-Fajfrowska
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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Soni K, Gour V, Agrawal P, Haider T, Kanwar IL, Bakshi A, Soni V. Carbopol-olive oil-based bigel drug delivery system of doxycycline hyclate for the treatment of acne. Drug Dev Ind Pharm 2021; 47:954-962. [PMID: 34280061 DOI: 10.1080/03639045.2021.1957916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The objective of this study was to prepare and evaluate the doxycycline hyclate containing bigel for the effective treatment of acne. METHODS Bigels are biphasic systems formed by water-based hydrogels and oil-based organogel. Carbopol 940 was used to prepare the hydrogel phase, whereas Span-60 and olive oil for the oleogel phase. RESULTS The microstructure of bigel confirmed the oil in water type emulsion formation. The average droplet size of formulations was found 15-50 µm, and a bell-shaped droplet distribution curve, rheological, or viscosity studies suggested that the consistency and stability of bigel decrease with high organogel concentration. Three formulations (F1, F2, and F3) of the different ratios of hydrogel:oleogel (60:40, 70:30, and 80:20) were prepared in which F1 was less stable compared to F2 and F3. The drug content of F2 and F3 was respectively 79.94 and 71.33%. Formulation F2 was found more effective as compared to F3 based on in vitro drug release studies. Bigel also showed better results during in vivo studies at the rabbit ear model, which reduce acne diameter up to 1.10 mm from 4.9 mm while gel reduced it up to 1.20 mm.
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Affiliation(s)
- Kumud Soni
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Vishal Gour
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Poornima Agrawal
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Tanweer Haider
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Indu Lata Kanwar
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Avijit Bakshi
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
| | - Vandana Soni
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University, Sagar, India
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Liu J, Liu L, Zhou L, Chen L, Chen X, Xiong X, Deng Y. The Effect of Intense Pulsed Light on the Skin Microbiota and Epidermal Barrier in Patients with Mild to Moderate Acne Vulgaris. Lasers Surg Med 2021; 53:1348-1355. [PMID: 34224604 DOI: 10.1002/lsm.23426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES The skin microbiota partly determined by epidermal barrier plays an important role in acne vulgaris and intense pulsed light (IPL) has been verified as a safe and effective therapeutic option for this disease. Nevertheless, the exact role of the IPL treatment on the skin microbiota and epidermal barrier for patients with acne vulgaris remains unclear. This article was designed to solve this problem. STUDY DESIGN/MATERIALS AND METHODS Nineteen healthy controls and 20 patients with mild to moderate acne were enrolled in this study, who received IPL treatment for 12 weeks. The epidermal barrier and skin samples were collected at baseline and after treatment. The microbial diversity was analyzed based on a high-throughput sequencing approach, which targets the V3-V4 region of the bacteria 16S ribosomal RNA genes. RESULTS After treatment of IPL, the Global Acne Grading System (GAGS) scores, sebum, sclererythrin, and red area of patients were significantly improved by IPL treatment (P < 0.05). Although there was no difference in microbiota diversity before and after IPL treatment, the Nonmetric Multidimension Scaling (NMDS) analysis showed that the samples of the acne patients before and after treatment could be divided into two different sets by skin microbiota (P = 0.011), which could be verified by heatmap analysis. Moreover, we found that the relative abundance of Staphylococcus epidermidis (S. epidermidis) significantly increased, but Cutibacterium acnes (C. acnes) decreased after IPL treatment. The sebum concentration was positively correlated with PH value (R = 0.525, P = 0.017), and the GAGS was positively associated with both sclererythrin (R = 0.477, P = 0.002) and red area (R = -0.503, P = 0.001). CONCLUSIONS IPL could successfully improve the GAGS scores of acne vulgaris, as well as regulate the equilibrium between C. acnes and S. epidermidis, and inhibit the sebum secretion. Lasers Surg. Med. © 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.
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Affiliation(s)
- Jiexiong Liu
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Lu Liu
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Lin Zhou
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Lingna Chen
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Xia Chen
- Department of Clinical Trial Center, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Xia Xiong
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Yongqiong Deng
- Department of Dermatology & STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
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Nikolakis G, von Stebut E. [Topical and novel device-based therapies for mild hidradenitis suppurativa]. Hautarzt 2021; 72:676-685. [PMID: 34223936 DOI: 10.1007/s00105-021-04849-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin folds, which requires more outpatient treatment alternatives. Although the disease was previously treated using surgery, new treatment modalities now allow the effective treatment of mild and moderate cases in an ambulatory care setting. AIM OF STUDY Local and instrument-based therapies are presented and their efficacy and safety profiles are highlighted. MATERIALS AND METHODS Clinical evidence for each therapeutic modality are presented and current treatment developments are analyzed based on the future treatment of HS patients in Germany. RESULTS Effective treatments for outpatient care of HS patients include topical clindamycin, resorcinol, and intralesional corticosteroids. New devices such as LAight therapy (combining intense pulsed light [IPL] with radiofrequency) are available, which can be used as monotherapy or adjunct therapy in combination with systemic treatment and/or surgery for the management of HS. CONCLUSION Evidence-based use of local treatments can provide more efficient outpatient and self-administered strategies, which improves the quality of life of HS patients, especially for patients with recurrent mild and moderate disease.
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Affiliation(s)
- G Nikolakis
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland.,European Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland
| | - E von Stebut
- Klinik für Dermatologie und Venerologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Zimmer S, Basien K, von Stebut E. [Impact of LAight therapy on hidradenitis suppurativa care]. Hautarzt 2021; 72:586-594. [PMID: 34125251 DOI: 10.1007/s00105-021-04843-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease with high burden for patients and limited treatment options. We recently analyzed the efficacy of local treatment with LAight therapy, a combination of intense pulsed light (IPL) and radiofrequency (RF). OBJECTIVES The aim of the present survey was to compare care of HS patients under LAight with standard care prior to therapy. MATERIALS AND METHODS The retrospective study included 111 patients who were treated with LAight at least 5 times between 01/2014 and 03/2017. Primary endpoint was the change in surgical interventions. Secondary endpoints included additional patient-reported outcomes, e.g., effects on their quality of life. RESULTS In all, 50 completed surveys were available for evaluation. Under LAight therapy, the number of surgical interventions decreased from 3.2 to 0.3 per year (p < 0.001). Secondary endpoints were also significantly improved: The days of sick leave/year due to HS decreased from 30.4 to 7.2 (p = 0.002), and the number of doctor appointments due to HS flare ups was altered from 7.3 to 1.5 (p < 0.001). In line, patient-reported pain levels, general wellbeing and quality of life were also improved. CONCLUSION This retrospective assessment of patient-reported treatment outcomes of 50 HS cases after treatment with LAight revealed a significant reduction of required surgical interventions and sick-days along with improved quality of life. Thus, it appears that IPL + RF treatment not only improves disease activity, but also secondary care aspects. Future studies will need to confirm these findings in a controlled setting.
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Affiliation(s)
- Sophia Zimmer
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Kyra Basien
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Esther von Stebut
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Radiofrequency Irradiation Attenuates High-Mobility Group Box 1 and Toll-like Receptor Activation in Ultraviolet B-Induced Skin Inflammation. Molecules 2021; 26:molecules26051297. [PMID: 33670841 PMCID: PMC7957621 DOI: 10.3390/molecules26051297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 12/27/2022] Open
Abstract
Ultraviolet B (UVB) exposure activates various inflammatory molecules of keratinocytes in the epidermis layer. Such UVB-mediated skin inflammation leaves post-inflammatory hyperpigmentation (PIH). Reports show a close relationship between PIH and high-mobility group box 1 (HMGB1) and its receptors. General clinical treatments of PIH, such as oral medication and laser treatment, have reported side effects. Recent studies reported the effects of radiofrequency (RF) irradiation on restoring dermal collagen, modulating the dermal vasculature, and thickening the basement membrane. To validate how RF regulates the inflammatory molecules from UVB-irradiated keratinocytes, we used UVB-radiated keratinocytes and macrophages, as well as animal skin. In addition, we examined two cases of RF-irradiated skin inflammatory diseases. We validated the effects of RF irradiation on keratinocytes by measuring expression levels of HMGB1, Toll-like receptors (TLRs), and other inflammatory factors. The results show that the RF modulates UVB-radiated keratinocytes to secrete fewer inflammatory factors and also modulates the expression of macrophages from HMGB1, TLRs, and inflammatory factors. RF irradiation could alleviate inflammatory skin diseases in patients. RF irradiation can regulate the macrophage indirectly through modulating the keratinocyte and inflammatory molecules of macrophages reduced in vitro and in vivo. Although the study is limited by the low number of cases, it demonstrates that RF irradiation can regulate skin inflammation in patients.
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Combining Deroofing with LAight ® Therapy for Long-Term Disease Control of Hurley Stage II Hidradenitis Suppurativa: Case Report. Clin Pract 2021; 11:26-31. [PMID: 33506816 PMCID: PMC7924316 DOI: 10.3390/clinpract11010005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/14/2022] Open
Abstract
There is an increasing consensus that the treatment of Hidradenitis suppurativa (HS) significantly varies with the degree of inflammation and that treatment according to guidelines is not always successful. Here, we report the case of a 31-year-old male with widespread, highly inflammatory Hurley Stage II HS in multiple locations who failed to respond to any kind of established medical treatment, including biologics. As an alternative approach, Ustekinumab was maintained, and additionally the patient was treated with LAight therapy, a combination of intense pulsed light and radiofrequency. After 10 sessions, deroofing of multiple lesions was performed in a two-step process. After a few weeks of healing time accompanied by specialized wound experts, the patient continued with LAight therapy to control and prevent recurrence. This case shows that the combination of LAight therapy and deroofing is a promising treatment plan for the long-term symptom control of mild and moderate HS.
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