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Results for “Photosensitivity Disorders”

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At least 163 records · Page 9Linked to original sources
PubMed2006

Split-face comparison of photodynamic therapy with 5-aminolevulinic acid and intense pulsed light versus intense pulsed light alone for photodamage.

BACKGROUND: Photodynamic therapy (PDT) with a 5-aminolevulinic acid (ALA) photosensitizing agent and a variety of lasers and light sources has been shown to enhance the treatment of photodamaged skin and its associated actinic keratoses (AKs). The efficacy of short-contact, full-face ALA by PDT in photorejuvenation has also been demonstrated. OBJECTIVE: To evaluate short-contact (30 to 60 min) ALA-PDT with intense pulsed light (IPL) activation by comparing ALA-PDT-IPL with IPL alone. METHODS Sixteen patients were enrolled in a split-face study. One side of each patient's face received ALA-PDT-IPL and the other side received IPL alone. Three treatments were given at 1-month intervals, and follow-up visits occurred at 1 and 3 months after the final treatment. RESULTS: Thirteen patients completed the trial. Three months after the final treatment, improvement was greater in the ALA-PDT-IPL side than in IPL-alone side for all facets of photodamage-crow's feet appearance (55 vs 29.5%), tactile skin roughness (55 vs 29.5%), mottled hyperpigmentation (60.3 vs 37.2%), and telangectasias (84.6 vs 53.8%). The clearance rate of AK lesions was also higher (78 vs 53.6%). CONCLUSION: Short-contact ALA-PDT-IPL brings about greater improvement in photodamaged skin and greater clearance of AK lesions than IPL alone, further confirming the usefulness of ALA-PDT in photorejuvenation.

Adult↗
PubMedDate not supplied

Bath PUVA--an investigation of the distribution of trioxsalen (TMP) and 8-methoxypsoralen (8-MOP) in bathwater.

Trioxsalen (TMP) bath PUVA avoids the side effects of nausea and headache associated with oral 8-methoxypsoralen (8-MOP) treatment and allows shorter irradiation times that can be advantageous in some patients. However we noted that a number of patients developed unusual patterns of phototoxic burning. We thought that this was related to an uneven distribution of the TMP in the bathwater and for this reason, a study of bath water TMP concentrations achieved using different TMP preparations was undertaken. The distribution of 8-MOP in an 8-MOP bath was also measured for comparison. Our results confirm that an uneven distribution of TMP is achieved using TMP capsules or suspension and would explain our observed patterns of burning. With an ethanolic solution of TMP, or the commercial equivalent Tripsor, or with Puvasoralen-8 (an 8-MOP preparation), a homogeneous psoralen distribution is achieved, and they are therefore preferable for use in bath PUVA.

Administration, Cutaneous↗
PubMed1997

Photodermatitis from ketoprofen with cross-reactivity to fenofibrate and benzophenones.

The aim of this study was to evaluate the possibility of cross-reactivity between ketoprofen, fenofibrate and benzophenones because of their structural similarities. Seven patients presenting photodermatitis from ketoprofen underwent patch and photopatch tests. Ketoprofen, fenofibrate, benzophenone 3, benzophenone 10, benzophenone 4, personal medications and topical creams were tested. All patients had positive patch or photopatch tests to ketoprofen and fenofibrate, four patients had positive UVA photopatch tests to benzophenone 3, and two to benzophenone 10. Patients presenting photosensitization to ketoprofen may also have cross-reactivity to fenofibrate and some benzophenones.

Adult↗
PubMedDate not supplied

Assessment of skin types, skin colours and cutaneous responses to ultraviolet radiation in an Asian population.

Ninety normal individuals were included in this study on skin types, skin colours and cutaneous responses to ultraviolet radiation. Skin types were recorded using Fitzpatrick's classification, skin colours were measured using the Minolta Chromameter CR-300, and cutaneous responses to UV radiation were measured in terms of minimal erythema dose (MED) to UVA, UVB and the immediate pigment darkening dose to UVA (IPDDA). Skin colour measurements were taken from the right cheek to represent facultative skin colours, and from the buttock to represent constitutive skin colours. The colours measured were expressed by the L x a x b colour space. Skin types and some colour parameters (L and b from covered parts of body) correlated fairly well with the minimal erythema doses (MED) to UVA and UVB. Skin colour measurements are more objective than skin type assessment and could be better markers of photosensitivity. However, there is still considerable overlap in MEDs for persons with different skin colours, and further studies of these parameters are warranted. Our MEDs are higher than other reports on similar skin types and skin colours. This could be due to differences in methodology, genetic make-up or acclimatization from chronic sun exposure. This illustrates the importance of local controls for each institution dealing with photosensitive disorders.

Adult↗
PubMed2006

Tumor vascular permeabilization by vascular-targeting photosensitization: effects, mechanism, and therapeutic implications.

PURPOSE: Loss of vascular barrier function has been observed shortly following vascular-targeting photodynamic therapy. However, the mechanism involved in this event is still not clear, and the therapeutic implications associated with this pathophysiologic change have not been fully explored. EXPERIMENTAL DESIGN: The effect of vascular-targeting photodynamic therapy on vascular barrier function was examined in both s.c. and orthotopic MatLyLu rat prostate tumor models and endothelial cells in vitro, using photosensitizer verteporfin. Vascular permeability to macromolecules (Evans blue-albumin and high molecular weight dextran) was assessed with dye extraction (ex vivo) and intravital microscopy (in vivo) methods. Intravital microscopy was also used to monitor tumor vascular functional changes after vascular-targeting photodynamic therapy. The effects of photosensitization on monolayer endothelial cell morphology and cytoskeleton structures were studied with immunofluorescence staining. RESULTS: Vascular-targeting photodynamic therapy induced vascular barrier dysfunction in the MatLyLu tumors. Thus, tumor uptake of macromolecules was significantly increased following photodynamic therapy treatments. In addition to vascular permeability increase, blood cell adherence to vessel wall was observed shortly after treatment, further suggesting the loss of endothelial integrity. Blood cell adhesion led to the formation of thrombi that can occlude blood vessels, causing vascular shutdown. However, viable tumor cells were often detected at tumor periphery after vascular-targeting photodynamic therapy. Endothelial cell barrier dysfunction following photodynamic therapy treatment was also observed in vitro by culturing monolayer endothelial cells on Transwell inserts. Immunofluorescence study revealed microtubule depolymerization shortly after photosensitization treatment and stress actin fiber formation thereafter. Consequently, endothelial cells were found to retract, and this endothelial morphologic change led to the formation of intercellular gaps. CONCLUSIONS: Vascular-targeting photodynamic therapy permeabilizes blood vessels through the formation of endothelial intercellular gaps, which are likely induced via endothelial cell microtubule depolymerization following vascular photosensitization. Loss of endothelial barrier function can ultimately lead to tumor vascular shutdown and has significant implications in drug transport and tumor cell metastasis.

Animals↗
PubMed1999

Polymorphous light eruption. A case report and consideration of the hardening mechanism.

BACKGROUND: Polymorphous light eruption (PLE) is a common form of photodermatosis. The pathogenesis of the disease and the mechanism of the hardening phenomenon, however, have not been clarified. OBSERVATION: We report a 62-year-old Japanese woman with PLE. Provocation and hardening induction testing revealed that hardening was induced at the sites irradiated by a sufficient dose of UV for reproduction of the lesion. Topical steroid could prevent a positive reaction but not the hardening induction. The expression of adhesion molecules and CD1a was decreased at the hardening site. CONCLUSION: From these results, the hardening phenomenon in our case might be due to immunosuppression by UV exposure supported by the down-regulation of cell adhesion molecule expression and partially due to the depletion of endogenous antigens which cause a delayed-type hypersensitivity reaction.

Antigens, CD1↗
PubMed2004

Safety of verteporfin for treatment of subfoveal choroidal neovascular membranes associated with age-related macular degeneration.

Photodynamic therapy (PDT) is a novel treatment entity that exploits the photophysical properties of various photosensitive chemical entities which, upon light activation, results in targeted photooxidation and subsequent tissue destruction. The antiangiogenic properties of PDT have been adapted for treatment of subfoveal choroidal neovascular membranes due to disease states such as age-related macular degeneration (AMD). Historically, PDT has been limited by a lack of suitable photosensitive dyes. However, agents such as verteporfin, a second-generation benzoporphyrin derivative, appear to be free from the extensive phototoxicity that limited the success of previous agents. Verteporfin has a high affinity for choroidal neovascular membranes, typically found with exudative AMD, and upon photoactivation results in targeted microvascular damage and thrombus formation with resultant vessel occlusion. Scrutiny of diagnostic indicators for verteporfin administration, including critical angiographic evaluation of lesion size and visual acuity, is essential to treatment success. Large lesions with relatively good visual acuity (20/50 or better) may be at particular risk for marked vision loss following verteporfin administration. Lesion composition also appears to influence visual outcome with verteporfin use. The safety of verteporfin is directly dependent upon the appropriate integration of dosage, infusion and light activation required for a suitable pharmacotherapeutic outcome. When used appropriately, and with adequate patient education regarding photosensitivity, the risk-benefit of verteporfin for the medical treatment of neovascular AMD is favourable.

Aged↗
PubMedDate not supplied

In vitro and in vivo photosensitization by protoporphyrins possessing different lipophilicities and vertical localization in the membrane.

Photodynamic therapy (PDT) is being evaluated in clinical trials for treatment of various oncologic and ophthalmic diseases. The main cause for cell inactivation and retardation of tumor growth after photoactivation of sensitizers is very short-lived singlet oxygen molecules that are produced and have limited diffusion distances. In this paper we show that the extent of biological damage can be modulated by using protoporphyrin, which was modified to increase its lipophilicity, and which also places the tetrapyrrole core deeper within the membrane by the carboxylate groups being anchored at the lipid:water interface. The uptake of the parent molecule (PPIX) and its diheptanoic acid analogue (PPIXC6) by WiDR and CT26 cells was investigated by fluorescence microscopy and by fluorescence intensity from the cells. The uptake of PPIXC6 increased almost linearly with incubation length for over 24 h, whereas for PPIX only 1 h was needed to reach maximal intracellular concentration. Fluorescence microscopy of both cell lines indicated that both drugs were distributed diffusely in the plasma membrane and cytoplasm, but remained outside the nucleus. The efficiency of in vitro inactivation of WiDr and CT26 cells increased with the length of the alkylcarboxylic chain. Tumors in mice that were treated with PPIX-PDT grew more slowly than control tumors. However, tumors that were given PPIXC6 followed by light exposure showed a significant delay in their growth.

Biological Transport↗
PubMed1993

Photodynamic properties of Sn-protoporphyrin: clinical investigations and phototesting in human subjects.

Pure synthetic metalloporphyrins have been developed for experimental and clinical use as inhibitors of heme oxygenase, the rate limiting enzyme in the catabolism of heme to bilirubin. Tin (Sn)-protoporphyrin is one such compound, which potently suppresses bilirubin production and thus jaundice in animals and man. We have previously reported that this metalloporphyrin in conjunction with UVA might be useful as a treatment for psoriasis. To assess the photodynamic properties of Sn-protoporphyrin, 31 subjects were investigated with regard to photosensitivity. In all subjects, phototesting using UVB, UVA, and visible light as well as photopatch testing was performed. Our investigations revealed that 16 of the 31 individuals treated with Sn-protoporphyrin developed a mild photosensitivity, mainly erythema of the hands and face, and in some cases a mild conjunctivitis. The duration of this sensitivity, which in no case caused discomfort, was dose-dependent and ranged from several weeks to 1-3 months. After administration of Sn-protoporphyrin, lower thresholds were found for both UVA and visible light, but the sensitivity for UVB was normal and photopatch tests were negative. In summary, the photosensitivity observed during Sn-protoporphyrin administration was of limited duration and magnitude and did not occur in all subjects. Thus, the combination of photoactive synthetic metalloporphyrins and artificial light might prove to be useful as a regimen for the treatment of skin disease.

Adult↗
PubMed1993

Chloroquine phosphate: a long-term follow-up of drug concentrations in skin suction blister fluid and plasma.

Chloroquine is known to bind strongly to melanin and is accumulated in the skin. In dermatology, the drug is mainly used to treat photosensitivity disorders, but it has also been reported to cause sun sensitivity, especially in patients with rheumatoid arthritis. In the present study the concentrations of chloroquine phosphate in plasma and skin suction blister fluid (interstitial fluid in the skin) from 16 patients were studied by HPLC at steady-state (after 2 months' ingestion of 250 mg of the drug daily) and 2, 4 and 6-7 months after cessation of therapy. At steady-state the concentrations were similar in the two compartments, whereas after discontinuation the drug remained much longer in the skin than in the plasma. In tests using cow's eye melanin in vitro, UV irradiation failed to interact with the binding of chloroquine to melanin. It is speculated that the prolonged storage of the drug in the skin could be of importance for its therapeutic as well as adverse effects.

Adult↗
PubMed1999

Examination of psoralens-induced photodermatitis in Wistar rats under scanning electron microscopy.

The psoralens are photoactivated plant biosynthetic compounds which are found in several plant families, including common fruits and vegetables. Synthetic forms of the psoralens bergapten (5-methoxypsoralen) and xanthotoxin (8-methoxypsoralen) are extensively used in skin chemotherapy in combination with long-wave ultraviolet radiation (PUVA). Side effects of PUVA therapy are not, however, desirable, and this therapy has been linked with increased incidence of skin cancer in humans. The psoralens are known to be carcinogenic, mutagenic and teratogenic, and to cause photodermatitis. The main objective of this study was to document the effect of PUVA on the epidermis of rats. Female Wistar rats were administered dietary bergapten and/or xanthotoxin (0-200 mg/kg body) and exposed to UVA radiation (45 min./day) for four weeks. At the end of the four-week period the rats were sacrificed; skin samples were taken from the ears and the top part of the tail and fixed for examination by Scanning Electron Microscopy. The animals subjected to PUVA had significantly smaller scales on the tail epidermis (mean scale size for the control 926 mu vs. 725 to 805 mu for the psoralen treatment groups. The rats that received dietary psoralens also had significantly less hair on the ears compared with the control animals (mean number of hairs per millimeter over the ear edge for the control 54.9 vs. 2.00 to 10.7 for the treatment groups). The two compounds were synergistic in their ability to reduce scale size on the tail epidermis.

5-Methoxypsoralen↗
PubMed1999

Critical overview: adverse cutaneous reactions to psychotropic medications.

BACKGROUND: Adverse cutaneous reactions (ACRs) are common, potentially life-threatening or symptomatically and cosmetically unappealing side effects of psychotropic drugs. DATA SOURCES: A MEDLINE search of the literature was employed to cite the association of various psychotropic drugs with specific cutaneous reactions. DATA SYNTHESIS: In addition to the common exanthematous eruption, we explore several serious reactions including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, angioedema, anaphylaxis, hypersensitivity syndrome, hypersensitivity vasculitis, erythroderma, and drug-induced lupus erythematosus. Other side effects such as alopecia, pigmentary disorders, photosensitivity, lichenoid lesions, fixed drug eruptions, and psoriasiform, acneiform, and seborrheic eruptions are discussed. Attention is paid to the morphology and distribution, systemic findings, diagnosis, and treatment of these conditions. CONCLUSION: Awareness of ACRs will allow psychiatrists to deter their continuation or recurrence, educate patients who have them, and diagnose serious instances of them.

Anaphylaxis↗
PubMed2000

Elucidation of the HIV-1 virucidal mechanism of methylene blue photosensitization and the effect on primary isolates.

The antiviral activity for primary isolates of human immunodeficiency virus (HIV) type 1 of a combination of methylene blue and light irradiation was investigated, in comparison with their virucidal effects on laboratory-adapted HIV-1. The antiviral mechanism was evaluated in terms of reverse transcriptase activity and viral RNA in the same viral stock. Despite a marked reduction in RNA (>3.07 Log(10)) and infectivity (6.10 Log(10)) under conditions of 1 microM methylene blue and 5 J/cm(2) irradiation when HIV-1(HTLV-IIIB) as a representative HIV-1 was employed, relatively little degradation of the viral envelope (0.20 Log(10)) and reverse transcriptase activity (1.52 Log(10)) was observed. Because no difference in the reduction of infectivity was found between primary isolates and laboratory-adapted HIV-1 (including HIV-2(ROD)), the antiviral mechanism of methylene blue photosensitization may be similar for all types of HIVs. Methylene blue photosensitization seems to deprive HIVs of infectivity, mainly due to RNA damage, and weak structural and functional damage of viral proteins.

Adaptation, Physiological↗
PubMed2000

Recent advances in phototherapy.

This synopsis reviews recent developments in dermatological phototherapy. UVA1 phototherapy (340-400 nm) is effective in the treatment of inflammatory skin diseases such as acutely exacerbated atopic dermatitis, localized scleroderma, urticaria pigmentosa and disseminated granuloma annulare. Narrowband UVB radiation (311-313 nm) is used successfully as monotherapy or combined with dithranol, oral retinoids or 8-MOP in psoriasis, atopic dermatitis (AD) or photosensitivity disorders such as polymorphic light eruption. Bath water delivery of 8-methoxypsoralen and subsequent UVA-irradiation (PUVA bath therapy) for the treatment of psoriasis as well as for mycosis fungoides, localized scleroderma, urticaria pigmentosa or lichen planus is an effective alternative to its systemic application. The combination of salt water brine baths in different concentrations and subsequent UVA/B irradiation is used increasingly for the treatment of psoriasis or AD. Extracorporeal photopheresis (ECP) has proven to be a very effective treatment modality for cutaneous T cell lymphoma, chronic graft-versus-host disease and certain autoimmune diseases such as systemic scleroderma or pemphigus. However, despite the documented benefits of these new treatment modalities, little data exist as of yet on potential long-term side effects, thus the indications for these therapies should be considered carefully and patients should be followed up at regular intervals.

Female↗