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Anais Brasileiros de Dermatologia 2021Of all the therapeutic options available in Dermatology, few of them have the history, effectiveness, and safety of phototherapy. Heliotherapy, NB-UVB, PUVA, and UVA1...
Of all the therapeutic options available in Dermatology, few of them have the history, effectiveness, and safety of phototherapy. Heliotherapy, NB-UVB, PUVA, and UVA1 are currently the most common types of phototherapy used. Although psoriasis is the most frequent indication, it is used for atopic dermatitis, vitiligo, cutaneous T-cell lymphoma, and cutaneous sclerosis, among others. Before indicating phototherapy, a complete patient assessment should be performed. Possible contraindications should be actively searched for and it is essential to assess whether the patient can come to the treatment center at least twice a week. One of the main method limitations is the difficulty that patients have to attend the sessions. This therapy usually occurs in association with other treatments: topical or systemic medications. Maintaining the regular monitoring of the patient is essential to identify and treat possible adverse effects. Phototherapy is recognized for its benefits and should be considered whenever possible.
Topics: Humans; Phototherapy; Psoriasis; Skin Neoplasms; Treatment Outcome; Ultraviolet Therapy; Vitiligo
PubMed: 33849754
DOI: 10.1016/j.abd.2021.03.001 -
Journal Der Deutschen Dermatologischen... Aug 2023Despite the development of highly effective biologics for skin diseases such as psoriasis or atopic dermatitis, UVA and UVB therapy, alone or in combination, are still... (Review)
Review
Despite the development of highly effective biologics for skin diseases such as psoriasis or atopic dermatitis, UVA and UVB therapy, alone or in combination, are still essential components of various guidelines. Phototherapy is not only a first-line treatment and highly effective for a number of skin diseases, but is also economical and has few side effects. The targeted use of UVA and UVB, if necessary, in combination with the photosensitizer psoralen in the context of PUVA therapy, enables the dermatologist to effectively treat a wide variety of skin diseases. Indications for phototherapy include epidermal diseases such as atopic dermatitis, psoriasis and vitiligo, as well as photodermatoses, mycosis fungoides, graft-versus-host disease and deep dermal diseases such as scleroderma. This article reviews the physical principles, molecular mechanisms, current treatment regimens, and individual indications for phototherapy and photochemotherapy.
Topics: Humans; Dermatitis, Atopic; Phototherapy; Ultraviolet Therapy; PUVA Therapy; Psoriasis; Skin Neoplasms
PubMed: 37485907
DOI: 10.1111/ddg.15126 -
Journal of Controlled Release :... Sep 2020Microneedles (MNs), as an effective minimally invasive delivery route, when used to puncture the skin, can bypass the skin's stratum corneum (SC) to enter the skin... (Review)
Review
Microneedles (MNs), as an effective minimally invasive delivery route, when used to puncture the skin, can bypass the skin's stratum corneum (SC) to enter the skin microcirculation and achieve systemic administration. Additionally, the MN route has obvious advantages over other routes of administration, including simplicity, non-pain, readily-permitted transport of drugs (including DNA and metformin) and macromolecules (such as antibodies and proteins), good repeatability, and wide range of clinical applications and safety. MNs have been combined with various therapy strategies including photodynamic therapy (PDT) and photothermal therapy (PTT) to treat many diseases, and hold great promise for improving the diagnosis and treatment of diseases. Both MN-assisted PDT and PTT are light-mediated phototherapy methods and have unique advantages, including improved selectivity, and minimal invasiveness and side effects. MN-assisted PDT or PTT has been studied for various applications by many research groups and pharmaceutical companies worldwide. Therefore, this review summarizes recent advances in MNs for PDT or PTT.
Topics: Administration, Cutaneous; Gold; Photochemotherapy; Phototherapy; Photothermal Therapy
PubMed: 32619742
DOI: 10.1016/j.jconrel.2020.06.032 -
Nature Reviews. Clinical Oncology Nov 2020Light-activated, photosensitizer-based therapies have been established as safe modalities of tumour ablation for numerous cancer indications. Two main approaches are... (Review)
Review
Light-activated, photosensitizer-based therapies have been established as safe modalities of tumour ablation for numerous cancer indications. Two main approaches are available: photodynamic therapy, which results in localized chemical damage in the target lesions, and photothermal therapy, which results in localized thermal damage. Whereas the administration of photosensitizers is a key component of photodynamic therapy, exogenous photothermal contrast agents are not required for photothermal therapy but can enhance the efficiency and efficacy of treatment. Over the past decades, great strides have been made in the development of phototherapeutic drugs and devices as cancer treatments, but key challenges have restricted their widespread clinical use outside of certain dermatological indications. Improvements in the tumour specificity of photosensitizers, achieved through targeting or localized activation, could provide better outcomes with fewer adverse effects, as could combinations with chemotherapies or immunotherapies. In this Review, we provide an overview of the current clinical progress of phototherapies for cancer and discuss the emerging preclinical bioengineering approaches that have the potential to overcome challenges in this area and thus improve the efficiency and utility of such treatments.
Topics: Clinical Trials as Topic; Humans; Nanotechnology; Neoplasms; Photochemotherapy; Photosensitizing Agents; Photothermal Therapy; Research Design; Treatment Outcome
PubMed: 32699309
DOI: 10.1038/s41571-020-0410-2 -
Anales de Pediatria Feb 2020Neonatal jaundice is common, especially in premature infants. Compliance with treatment protocols and standard serum bilirubin curves forces the clinician to separate... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
Neonatal jaundice is common, especially in premature infants. Compliance with treatment protocols and standard serum bilirubin curves forces the clinician to separate the child from the mother after birth for short phototherapy. The objective of this study is to evaluate the effectiveness and safety of two innovative devices for phototherapy including a LED light mesh: one sleeping bag and one blanket compared to conventional hospital or ambulatory phototherapy.
METHODS
Two randomised clinical trials were conducted: one with newborns >2,000g at birth in the Neonatal Care Unit and the other with premature infants followed-up in an outpatient clinic (PMC). The gold standard for bilirubin measurement was serum bilirubin, and ambulatory controls were performed with the Bilicheck®. Parents and health personnel completed a questionnaire on comfort and perceptions.
RESULTS
In the study using the bag, a linear regression was performed for the decrease in bilirubin in mg/dL/h, controlling by early jaundice (<36h) and the device type. The results were similar between the 2 devices. For the blanket trial in the PMC, the decrease in bilirubin levels with the new device was significantly greater with no differences in temperatures, duration of phototherapy, re-admission, mortality, or side effects for both trials. Parents and staff satisfaction with the two devices was identical for the 2 trials.
CONCLUSION
These 2 small studies add a 'grain of sand' to humanisation of newborn care, avoiding the mother-and-child separation for both the intra-hospital high-risk hyperbilirubinaemia, as well as for the lower-risk hyperbilirubinaemia in an outpatient clinic.
Topics: Bilirubin; Female; Humans; Infant, Newborn; Infant, Premature; Jaundice, Neonatal; Male; Phototherapy; Surveys and Questionnaires
PubMed: 30979682
DOI: 10.1016/j.anpedi.2019.02.008 -
International Journal of Nanomedicine 2020The ultimate goal of phototherapy based on nanoparticles, such as photothermal therapy (PTT) which generates heat and photodynamic therapy (PDT) which not only generates... (Review)
Review
The ultimate goal of phototherapy based on nanoparticles, such as photothermal therapy (PTT) which generates heat and photodynamic therapy (PDT) which not only generates reactive oxygen species (ROS) but also induces a variety of anti-tumor immunity, is to kill tumors. In addition, due to strong efficacy in clinical treatment with minimal invasion and negligible side effects, it has received extensive attention and research in recent years. In this paper, the generations of nanomaterials in PTT and PDT are described separately. In clinical application, according to the different combination pathway of nanoparticles, it can be used to treat different diseases such as tumors, melanoma, rheumatoid and so on. In this paper, the mechanism of pathological treatment is described in detail in terms of inducing apoptosis of cancer cells by ROS produced by PDT, immunogenic cell death to provoke the maturation of dendritic cells, which in turn activate production of CD4+ T cells, CD8+T cells and memory T cells, as well as inhibiting heat shock protein (HSPs), STAT3 signal pathway and so on.
Topics: Animals; Antineoplastic Agents; Apoptosis; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cytokines; Humans; Hyperthermia, Induced; Nanoparticles; Neoplasms; Photochemotherapy; Photosensitizing Agents; Phototherapy; Reactive Oxygen Species
PubMed: 32982235
DOI: 10.2147/IJN.S269321 -
Dermatologic Clinics Jan 2020Vitiligo is a common disorder with a severe impact on quality of life. The authors review recent advances in phototherapy for vitiligo focusing on narrowband ultraviolet... (Review)
Review
Vitiligo is a common disorder with a severe impact on quality of life. The authors review recent advances in phototherapy for vitiligo focusing on narrowband ultraviolet B including mechanisms, treatment recommendations, and combination therapies. Phototherapy is the first-line treatment of choice for vitiligo with narrowband UVB preferred for widespread vitiligo and excimer used for localized lesions. However, unfamiliarity with prescribing phototherapy may be limiting clinicians from using it to its full potential. This article provides clinicians with the critical information needed to safely and effectively provide phototherapy for their patients with vitiligo.
Topics: Humans; Phototherapy; Treatment Outcome; Vitiligo
PubMed: 31753192
DOI: 10.1016/j.det.2019.08.005 -
Journal of the European Academy of... Nov 2023The treatment of vitiligo can be challenging. Up-to-date agreed consensus recommendations on the use of topical and systemic therapies to facilitate the clinical...
Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force-Part 2: Specific treatment recommendations.
BACKGROUND
The treatment of vitiligo can be challenging. Up-to-date agreed consensus recommendations on the use of topical and systemic therapies to facilitate the clinical management of vitiligo are currently lacking.
OBJECTIVES
To develop internationally agreed-upon expert-based recommendations for the treatment of vitiligo.
METHODS
In this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in different online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence for different topics included in the algorithms. A survey was then given to a core group of eight experts to resolve the remaining issues. Subsequently, the recommendations were finalized and validated based on further input from the entire group during two live meetings.
RESULTS
The recommendations provided summarize the latest evidence regarding the use of topical therapies (steroids, calcineurin inhibitors and Jak-inhibitors) and systemic therapies, including steroids and other systemic immunomodulating or antioxidant agents. The different modalities of phototherapies (NB-UVB, photochemotherapy, excimer devices and home phototherapy), which are often combined with other therapies, are also summarized. Interventional approaches as well as depigmentation strategies are presented for specific indications. Finally, the status of innovative and targeted therapies under development is discussed.
CONCLUSIONS
This international consensus statement culminated in expert-based clinical practice recommendations for the treatment of vitiligo. The development of new therapies is ongoing in vitiligo, and this will likely improve the future management of vitiligo, a disease that still has many unmet needs.
Topics: Humans; Vitiligo; Phototherapy; Ultraviolet Therapy; Photochemotherapy; Steroids; Treatment Outcome; Combined Modality Therapy
PubMed: 37715487
DOI: 10.1111/jdv.19450 -
Dermatologic Clinics Jan 2020Phototherapy is an effective treatment for multiple dermatoses. However, patient inconvenience and poor access to office-based phototherapy may jeopardize adherence and... (Review)
Review
Phototherapy is an effective treatment for multiple dermatoses. However, patient inconvenience and poor access to office-based phototherapy may jeopardize adherence and treatment outcome. Home phototherapy offers a convenient, accessible, and effective therapy. We describe the history of home phototherapy, the devices available, and associated costs. A literature review used PubMed. Keywords included: "home phototherapy," "tanning beds," "narrowband ultraviolet B." In a randomized control trial, home phototherapy had similar efficacy to office-based phototherapy. Home phototherapy is associated with significant cost savings treatment and increased adherence. Home phototherapy should be considered for its economic value, good tolerability, adherence, and efficacy.
Topics: Home Care Services; Humans; Phototherapy; Skin Diseases
PubMed: 31753183
DOI: 10.1016/j.det.2019.09.001 -
Dermatologic Clinics Jan 2020Phototherapy is an effective treatment modality for many types of pruritus. Although the exact mechanisms by which phototherapy reduces itch vary across pruritic... (Review)
Review
Phototherapy is an effective treatment modality for many types of pruritus. Although the exact mechanisms by which phototherapy reduces itch vary across pruritic conditions, its effects may result from immune suppression and/or neural modulation. In this article, the authors review the efficacy of different types of phototherapy for common inflammatory and noninflammatory pruritic conditions and discuss common side effects, such as erythema and exacerbation of pruritus. Although phototherapy may be an effective and relatively safe option for skin-directed treatment of chronic itch, barriers may exist for individual patients.
Topics: Disease Management; Humans; Phototherapy; Pruritus
PubMed: 31753187
DOI: 10.1016/j.det.2019.08.008