LL-37, the only human member of the cathelicidin family of antimicrobial peptides.

Vitiligo is an acquired pigmentary disorder of unknown etiology that is clinically characterized by the development of white macules related to the selective loss of melanocytes. The prevalence of the disease is around 1% in the United States and in Europe, but ranges from less than 0.1% to greater than 8% worldwide. A recorded predominance of women may reflect their greater willingness to express concern about cosmetically relevant issues. Half of all patients develop the disease before 20 years of age. Onset at an advanced age occurs but is unusual, and should raise concerns about associated diseases, such as thyroid dysfunction, rheumatoid arthritis, diabetes mellitus, and alopecia areata. Generalized vitiligo is the most common clinical presentation and often involves the face and acral regions. The course of the disease is unpredictable and the response to treatment varies. Depigmentation may be the source of severe psychological distress, diminished quality of life, and increased risk of psychiatric morbidity. Part I of this two-part series describes the clinical presentation, histopathologic findings, and various hypotheses for the pathogenesis of vitiligo based on past and current research.

https://www.jaad.org/article/S0190-9622(11)00039-9/pdf

Vitiligo: A comprehensive overview: Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up

Transdermal drug delivery offers a number of advantages for the patient, due not only its non-invasive and convenient nature, but also factors such as avoidance of first pass metabolism and prevention of gastrointestinal degradation. It has been demonstrated that microneedle arrays can increase the number of compounds amenable to transdermal delivery by penetrating the skin's protective barrier, the stratum corneum , and creating a pathway for drug permeation to the dermal tissue below. Microneedles have been extensively investigated in recent decades for drug and vaccine delivery as well as minimally invasive patient monitoring/diagnosis. This review focuses on a range of critically important aspects of microneedle technology, namely their material composition, manufacturing techniques, methods of evaluation and commercial translation to the clinic for patient benefit and economic return. Microneedle research and development is finally now at the stage where commercialisation is a realistic possibility. However, progress is still required in the areas of scaled-up manufacture and regulatory approval.

/pdf/microneedle-arrays-as-transdermal-and-intradermal-drug-2noob5nntj.pdf

Microneedle arrays as transdermal and intradermal drug delivery systems: Materials science, manufacture and commercial development

A comprehensive summary of LL-37, the factotum human cathelicidin peptide

Background and Objective

Photodynamic therapy (PDT) was discovered over 100 years ago by its ability to kill various microorganisms when the appropriate dye and light were combined in the presence of oxygen. However it is only in relatively recent times that PDT has been studied as a treatment for various types of localized infections. This resurgence of interest has been partly motivated by the alarming increase in drug resistance amongst bacteria and other pathogens. This review will focus on the clinical applications of antimicrobial PDT.



Study Design/Materials and Methods

The published peer-reviewed literature was reviewed between 1960 and 2011.



Results

The basics of antimicrobial PDT are discussed. Clinical applications of antimicrobial PDT to localized viral infections caused by herpes and papilloma viruses, and nonviral dermatological infections such as acne and other yeast, fungal and bacterial skin infections are covered. PDT has been used to treat bacterial infections in brain abscesses and non-healing ulcers. PDT for dental infections including periodontitis and endodontics has been well studied. PDT has also been used for cutaneous Leishmaniasis. Clinical trials of PDT and blue light alone therapy for gastric Helicobacter pylori infection are also covered.



Conclusion

As yet clinical PDT for infections has been mainly in the field of dermatology using 5-aminolevulanic acid and in dentistry using phenothiazinium dyes. We expect more to see applications of PDT to more challenging infections using advanced antimicrobial photosensitizers targeted to microbial cells in the years to come. Lasers Surg. Med. 43:755–767, 2011. © 2011 Wiley-Liss, Inc.

/pdf/photodynamic-therapy-for-infections-clinical-applications-4szjels2xl.pdf

Photodynamic therapy for infections: clinical applications.

BACKGROUNDAblative carbon dioxide (CO2) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma

The Efficacy of Autologous Platelet Rich Plasma Combined with Ablative Carbon Dioxide Fractional Resurfacing for Acne Scars: A Simultaneous Split-Face Trial

Background:Striae distensae (SD) are dermal scars characterized by linear atrophic depressions. Fractional photothermolysis (FP) is an effective modality for the treatment of cutaneous scars. Objective:To evaluate the safety and efficacy of FP for the treatment of SD in Asian skin. Methods:Six female volunteers aged between 20 and 35 years with chronic striae albae phase SD on both buttocks were enrolled. SD lesions on the right buttock were irradiated with a 1550-nm FP laser and patients were followed every 4 weeks for a total of 8 weeks. Outcome assessments included serial photographs, erythema index and melanin index tracking, skin elasticity, histologic examination, and the patients’ subjective satisfaction scores. Results:FP treatment was associated with a substantial improvement in the appearance of SD at 8 weeks post-treatment. The erythema index and melanin index of the treated SD lesions tended to converge with those of the control skin at 4-week follow-up. Skin elasticity was found to be partially normalized after FP. In addition, there was a significant increase in epidermal thickness, collagen, and elastic fiber deposition after FP as demonstrated by histologic examination. Adverse effects of FP included mild and transient pain and hyperpigmentation. Conclusion:FP can reduce SD by stimulating new collagen and elastic fiber synthesis. In addition, repetitive treatments might constitute an effective approach to improving the treatment of SD.

Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin

BACKGROUND Skin laxity is a common complaint of patients who request skin rejuvenation. Radiofrequency and infrared light are widely used for nonablative treatment of skin laxity. Intense focused ultrasound (IFUS) has been investigated as a tool for the treatment of solid benign and malignant tumors for many decades but is only now beginning to emerge as a potential noninvasive alternative to conventional nonablative therapy. OBJECTIVES To evaluate the efficacy of IFUS for the treatment of face and neck laxity. METHODS Twelve female volunteers were enrolled in the study, and 10 were ultimately evaluated. The device under investigation was an IFUS. Areas treated included the face and neck. For treatment, the 4-MHz, 4.5-mm probe was used first, followed by the 7-MHz, 3.0-mm probe. Two blinded, experienced clinicians evaluated paired pretreatment and post-treatment (day 90) photographs. Patient self-assessments were also obtained. RESULTS On the first primary outcome measure, two blinded clinicians felt that 8 of 10 subjects (80%) showed clinical improvement 90 days after treatment. Nine of 10 subjects (90%) reported subjective improvement.

Multiple Pass Ultrasound Tightening of Skin Laxity of the Lower Face and Neck

The human scalp harbors a vast community of microbial mutualists, the composition of which is difficult to elucidate as many of the microorganisms are not culturable using current culture techniques. Dandruff, a common scalp disorder, is known as a causative factor of a mild seborrheic dermatitis as well as pityriasis versicolor, seborrheic dermatitis, and atopic dermatitis. Lipophilic yeast Malassezia is widely accepted to play a role in dandruff, but relatively few comprehensive studies have been reported. In order to investigate fungal biota and genetic resources of dandruff, we amplified the 26S rRNA gene from samples of healthy scalps and dandruff-afflicted scalps. The sequences were analyzed by a high throughput method using a GS-FLX 454 pyrosequencer. Of the 74,811 total sequence reads, Basidiomycota (Filobasidium spp.) was the most common phylum associated with dandruff. In contrast, Ascomycota (Acremonium spp.) was common in the healthy scalps. Our results elucidate the distribution of fungal communities associated with dandruff and provide new avenues for the potential prevention and treatment of dandruff.

/pdf/characterization-of-the-fungal-microbiota-mycobiome-in-4l3xapzga3.pdf

Characterization of the Fungal Microbiota (Mycobiome) in Healthy and Dandruff-Afflicted Human Scalps

Background
Striae distensae are dermal scars characterized by flattening and atrophy of the epidermis. Although many treatment modalities have been attempted with variable results, there is no criterion standard treatment modality for striae distensae.

Objectives
To evaluate the effectiveness and safety of a disk microneedle therapy system (DTS) in the treatment of striae distensae.

Materials and methods
Sixteen Korean volunteers with striae distensae alba or rubra were enrolled. Patients received three treatments using a DTS at 4-week intervals. Clinical response to treatment was assessed by comparing pre- and post-treatment clinical photographs, skin biopsies, and patient satisfaction scores. Clinical improvement was assessed using the quartile grading scale.

Results
Marked to excellent improvement was noted in seven (43.8%) patients, with minimal to moderate improvement in the remaining nine. Patient satisfaction scores showed that six (37.5%) patients were highly satisfied, eight (50.0%) were somewhat satisfied, and two (12.5%) were unsatisfied. There were no significant side effects except mild pain, erythema, and spotty bleeding.

Conclusion
Disk microneedle therapy system (DTS) can be effectively and safely used in the treatment of striae distensae.

Myeung Nam Kim

Papers

The Efficacy of Autologous Platelet Rich Plasma Combined with Ablative Carbon Dioxide Fractional Resurfacing for Acne Scars: A Simultaneous Split-Face Trial

Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin

Multiple Pass Ultrasound Tightening of Skin Laxity of the Lower Face and Neck

Characterization of the Fungal Microbiota (Mycobiome) in Healthy and Dandruff-Afflicted Human Scalps

Treatment of striae distensae using needling therapy: a pilot study.