Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.

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Trends and targets in antiviral phototherapy

PACT therapy involves the use of a chemical dye which targets the organism cell wall, in this case the fungus. The dye is activated by a high powered lamp which starts a chemical reaction, and the release of oxygen into the affected nail plate. This sudden and prolonged release of oxygen helps to destroy the cell wall of the fungus and over the course of your treatment helps to eradicate it from your nail plate.

Photodynamic Antimicrobial Chemotherapy

The objective of this study was to present a systematic review of the central nervous system (CNS) types of anomalies and to consider the possibility to include CNS anomalies in Incontinentia pigmenti (IP) criteria. The analyzed literature data from 1,393 IP cases were from the period 1993–2012. CNS anomalies were diagnosed for 30.44% of the investigated IP patients. The total number of CNS types of anomalies per patient was 1.62. In the present study there was no significantly higher number of anomalies per patient in females than males. The most frequent CNS types of anomalies were seizures, motor impairment, mental retardation, and microcephaly. The most frequently registered CNS lesions found using brain imaging methods were brain infarcts or necrosis, brain atrophies, and corpus callosum lesions. IKBKG exon 4–10 deletion was present in 86.00% of genetically confirmed IP patients. The frequency of CNS anomalies, similar to the frequency of retinal anomalies in IP patients, concurrent with their severity, supports their recognition in the list of IP minor criteria.

/pdf/systematic-review-of-central-nervous-system-anomalies-in-2fcan0edjd.pdf

Systematic review of central nervous system anomalies in incontinentia pigmenti

This review briefly summaries the principles and mechanisms of action of photodynamic therapy (PDT) as concerns its application in the oncological field, highlighting its drawbacks and some of the strategies that have been or are being explored to overcome them. The major aim is to increase the efficiency and selectivity of the photosensitizer (PS) uptake in the cancer cells for optimizing the PDT effects on tumors while sparing normal cells. Some attempts to achieve this are based on the conjugation of the PS to biomolecules (small ligands, peptides) functioning as carriers with the ability to efficiently penetrate cells and/or specifically recognize and bind proteins/receptors overexpressed on the surface of cancer cells. Alternatively, the PS can be entrapped in nanocarriers derived from various types of materials that can target the tumor by exploiting the enhanced permeability and retention (EPR) effects. The use of nanocarriers is particularly attractive because it allows the simultaneous delivery of more than one drug with the possibility of combining PDT with other therapeutic modalities.

Strategies for optimizing the delivery to tumors of macrocyclic photosensitizers used in photodynamic therapy (PDT)

The focus of this review is to describe the state-of-art in the development of innovative drug delivery systems for phthalocyanines as photosensitizers for photodynamic therapy (PDT). PDT is a medical treatment combining photosensitizers (PSs) activated by visible light of a specific wavelength to selectively destroy targeted cells, tumor tissues and its surrounding vasculature. In the last decades, PDT has been under intense investigation, first as a promising alternative approach for improved cancer treatment, later against microbial infection and nowadays, mainly in aesthetic medicine, against age-related degeneration. The success of PDT is restricted because of difficulties with administration and skin permeation of PSs. As PDT importance raises, there is high interest for advanced formulations and delivery systems (DDS) for PS, especially formulations based on nanotechnology. Accordingly, this review deals with the innovations pertaining to DDS for PDT as disclosed in recent patents and literature.

Drug Delivery Systems for Phthalocyanines for Photodynamic Therapy.

Dear Editor: Androgenetic alopecia is the most frequent cause of inflammationinduced hair loss; however, the efficacy and safety of medicines approved by the Food and Drug Administration for the condition have been limited (Rousso & Kim, 2014; Varothai & Bergfeld, 2014). Because of the adverse effects of long-term finasteride use (Ali, Heran, & Etminan, 2015), many male patients are reluctant to take the drug. Recently, Freund and Schwartz reported an androgenetic alopecia treatment strategy involving the use of 150 units of botulinum toxin A, which has been proven effective and safe for facial rejuvenation (Freund & Schwartz, 2010; Gart & Gutowski, 2016). In the present study, considering differences in races and safety problems, the present authors used a smaller dose of Botox (50 U) diluted with 2.5 ml of 0.9% normal saline to treat androgenetic alopecia in Chinese patients. To evaluate the efficacy and safety of injections of a small dose of Botox, 25 male outpatients aged 30–45 years with androgenetic alopecia were included. All subjects were injected with 50 units of Botox into the muscles surrounding the scalp, including the frontalis, temporalis, periauricular, and occipitalis muscles, in equally divided doses at a minimum of 30 injection sites. All patients returned to the clinic for efficacy and safety evaluations before the treatment, and 3 and 6 months later. Treatment efficacy was evaluated based on the grease content of the scalp detected by Derma-Expert MC760 (Germany) and the hair count at each visit. The trial was completed in 24 patients, one patient dropped; the representative clinical improvement is shown in Figure 1. At 3 months, 9 patients showed obvious hair regrowth (>10% increase from baseline), 10 showed no apparent hair growth (0–10% increase from baseline), and 5 still showed hair loss. Furthermore, 19 patients showed a significant decrease in grease secretion, which reached the maximum level at 3 months. After 6 months of treatment, 11 patients exhibited remarkable hair regrowth (>10% increase from baseline), 8 showed a minimal improvement, and 5 showed no response to treatment. Furthermore, grease secretion gradually restored to the normal state in 19 patients who had shown a significant decrease in grease secretion at 3 months and the grease content was close to the healthy level. Importantly, no patient experienced adverse effects. Botulinum inhibits the release of stored neurotransmitters, causing flaccid paralysis of targeted muscles (Awan, 2017). According to Freund and Schwartz, in androgenetic alopecia patients, the muscles around the periphery lead to a tight scalp, reducing the blood flow at the distal ends of the vessels, especially, the vertex and front peaks. Botox loosens the scalp, reduces pressure on the perforating vasculature, and increases blood flow and oxygen concentration. With a high concentration of oxygen, more testosterone is converted into estradiol (Freund & Schwartz, 2010), leading to a decline in grease secretion and consequently hair loss. Thus, a small dose of Botox was proved effective and safe in Chinese patients in our study.

A small dose of botulinum toxin A is effective for treating androgenetic alopecia in Chinese patients

The external application of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT) results in a shallow penetration depth in thick or extensive condylomata acuminata (CA) lesions, thus demonstrating a poor therapeutic effect for those patients. To compare the efficacy of needle-free injection with external application of ALA in PDT for the treatment of CA, 160 CA patients with thick or extensive warts received ALA-PDT by means of external application or needle-free injection of ALA, respectively. The complete response (CR) rate and recurrence rate in the two groups were analyzed. The CR rate after the first treatment in the needle-free injection group (68.8%) was significantly higher compared with that in the external application group (52.5%; P=0.035). The recurrence rates in the needle-free injection group and external application group were 4.1 and 15.4%, respectively (P=0.022). The needle-free injection of ALA increases the therapeutic effect of PDT for CA patients with thick or extensive lesions. It shortens the treatment time and reduces the recurrence rate, and has great potential in the treatment of CA.

https://www.spandidos-publications.com/10.3892/etm.2013.1092/download

Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of condylomata acuminata.

Background
Photodynamic therapy (PDT) has been widely used in treatment for skin cancer. However, topical 5-aminolevulinic acid (ALA) in PDT demonstrates poor therapeutic effect due to its shallow penetration. And intralesional ALA-PDT can bring great pain. The purpose of this study was to evaluate the efficacy of PDT with needle-free injection of ALA in the treatment of nonmalignant skin tumors.

Methods
54 non-melanocytic malignant lesions of 54 subjects were treated with needle-free injection of 20% 5-ALA under occlusion for 1.5 hours, and irradiated with light dose of 100 J/cm2 at 100 mW for 20 minutes. Evaluation of treatment efficacy was conducted at 2 week after treatment.

Results
44 cases showed complete response with six cycles of PDT, three cases with seven cycles, and three cases with nine cycles. The remaining four cases failed to show complete response even with nine cycle of PDT. No case was reported to have recurrence in 6 months posttreatment. Only four cases experienced disease recurrence in 1 year posttreatment.

Conclusions
The treatment with PDT using needle-free injection of 5-ALA appears to be effective and well tolerated with milder therapeutic pain and low recurrence rate. It can be proposed as an effective treatment alternative for non-melanoma skin cancer.

Needle‐free injection of 5‐aminolevulinic acid in photodynamic therapy for the treatment of non‐melanoma skin cancer

Malignant acanthosis nigricans (MAN), characterized by the presence of a hyperpigmented, velvety cutaneous thickening, is recognized as a cutaneous sign of internal malignancy. Few MAN has been reported in the Asian race ever before. Here, we report a rare case of MAN with severe mucosa and soles and extraordinary facial involvement in the Asian race. A 74-year-old man presented with hyperkeratotic eruption for 7 months. Physical examination revealed hyperkeratotic plaques on the face, dorsal skin of fingers and heels, and papillomatosis of buccal mucosa. Biopsy findings from skin lesion revealed hyperkeratosis, papillomatosis, and hyperpigmentation of the basal layer. The endoscopic ultrasound with biopsy of the gastric tissue revealed gastric cardia tubular adenocarcinoma. The patient was diagnosed with MAN associated with gastric adenocarcinoma, immediately following tumor resection and lymphadenectomy. A slight improvement was seen in the skin condition but died of cancer cachexia 3 months later. We report our typical patient to highlight the importance of MAN, which was an early clue to the discovery of gastric adenocarcinoma.

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Malignant acanthosis nigricans: an early diagnostic clue for gastric adenocarcinoma.

Although standard itraconazole pulse therapy is a well-established regimen for toenail onychomycosis, the cure rate for onychomycosis remains low. To evaluate the efficacy and safety of different cycles of itraconazole pulse therapy, determine the optimal dosage and number of cycles for onychomycosis. A total of 90 outpatients of our hospital with onychomycosis were randomised into three treatment groups: (1) standard itraconazole pulse therapy (200 mg twice per day, 1 week each month for three pulses); (2) long-term pulse therapy (200 mg twice per day, 1 week each month for six pulses); (3) low-dose and long-term pulse therapy (200 mg/d, 1 week per month for six pulses) and were followed up for 15 months. Of the initial patients, the trial was completed by 81 patients. The complete cure rates were 32.43% for three cycles and 75% for six cycles (P < .001). For six cycles, despite the administration of half-dose for patients weighing no more than 55 kg, there was no statistical difference in the complete cure rate (P = .862). Long-term therapy is effective and safe for the treatment of toenail onychomycosis. For patients weighing no more than 55 kg, long-term half-dose itraconazole pulse therapy is recommended .

https://onlinelibrary.wiley.com/doi/pdf/10.1111/myc.12799

Xiuli Li

Papers

A small dose of botulinum toxin A is effective for treating androgenetic alopecia in Chinese patients

Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of condylomata acuminata.

Needle‐free injection of 5‐aminolevulinic acid in photodynamic therapy for the treatment of non‐melanoma skin cancer

Malignant acanthosis nigricans: an early diagnostic clue for gastric adenocarcinoma.

An exploration of the optimum dosage and number of cycles of itraconazole pulse therapy for severe onychomycosis.