Treatment of moderate to severe inflammatory acne vulgaris: photodynamic therapy with 5-aminolevulinic acid and a novel advanced fluorescence technology pulsed light source.

The use of photodynamic therapy (PDT) with 20% 5-aminolevulinic acid (ALA) for the treatment of acne vulgaris has been explored. This study evaluates the safety and efficacy of a new Advanced Fluorescence Technology (AFT) pulsed light source (420-950 nm) for photoactivation in ALA PDT for the treatment of moderate to severe inflammatory facial acne vulgaris. Nineteen subjects received 4 ALA PDT treatments with the AFT pulsed light source. Treatments were spaced 2 weeks apart. ALA was incubated for 15 to 30 minutes. At the end of the fourth treatment, the total reductions in inflammatory and noninflammatory lesion counts were 54.5% and 37.5%, respectively. Median Global Severity Scores suggest a trend toward reduction after several treatments. Investigator and subject assessments show moderate to marked improvement in most patients. The new AFT pulsed light source with ALA PDT appears to be a safe and effective modality for the treatment of moderate to severe inflammatory acne vulgaris.

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.

A multicenter clinical evaluation of the treatment of mild to moderate inflammatory acne vulgaris of the face with visible blue light in comparison to topical 1% clindamycin antibiotic solution.

BACKGROUND: Blue light sources have been shown to be effective in the treatment of mild to moderate inflammatory acne vulgaris lesions. OBJECTIVE: We evaluated the safety and efficacy of a new blue light source in the treatment of mild to moderate inflammatory acne vulgaris in comparison to topical 1% clindamycin solution. RESULTS: Blue light therapy reduced inflammatory acne vulgaris lesions by an average of 34%, as compared to 14% for topical 1% clindamycin solution. CONCLUSIONS: The blue light source presented in this report is a safe and effective treatment option available to our patients with mild to moderate inflammatory acne lesions.

Treatment of sebaceous gland hyperplasia by photodynamic therapy with 5-aminolevulinic acid and a blue light source or intense pulsed light source.

Treatment of SGH by ALA-PDT with Blue Light Source or Intense Pulsed Light Activation. Sebaceous gland hyperplasia (SGH) lesions often present as a sign of photoaging and have proven difficult to treat. Photodynamic therapy (PDT) may be an effective treatment option. Twelve patients with SGH received PDT with 5-aminolevulinic acid (ALA, Levulan Kerastick, DUSA Pharmaceuticals, Inc) photosensitizing agent topically applied with a 30- to 60-minute drug incubation period. Patients received either 405-420 nm blue light (ClearLight PhotoClearing System, CureLight, Lumenis) for 15 minutes or intense pulsed light (IPL), 500-1,200 nm and 550 nm cut-off filter (VascuLight System, Lumenis) according to a randomization protocol. ALA-PDT was administered once per month for 4 consecutive months. Progress was evaluated at 4 and 12 weeks after the final treatment. More than a 50% reduction in the number of SGH lesions was achieved for patients in both treatment arms without lesional recurrence during the treatment and follow-up periods. All treatments were well-tolerated. Adverse effects were limited to mild, transient erythema (n = 2) and blisters (n = 1), which resolved without sequelae. ALA-PDT with either blue light or IPL photoactivation may provide therapeutic benefit without significant adverse effects in patients with SGH.

The use of a novel intense pulsed light and heat source and ALA-PDT in the treatment of moderate to severe inflammatory acne vulgaris.

The use of lasers and noncoherent light sources is becoming more commonplace in the treatment of inflammatory acne vulgaris. Topical 5-aminolevulinic acid (ALA) is finding its niche as an enhancer to these laser and light sources. Twenty patients with moderate to severe inflammatory acne vulgaris were enrolled in a clinical trial to evaluate the efficacy of ALA-PDT with activation by a SkinStation LHE (Radiancy, Inc., Orangeburg, NY), a novel intense pulsed light (IPL) and heat source that emits 430-nm to 1100-nm radiation at 3 to 9 J/cm2 fluences. Patients were given topical ALA (Levulan Kerastick, Dusa Pharmaceuticals, Inc., Wilmington, MA) photosensitizing agent that remained in contact with skin for one hour before irradiation. Fifteen patients completed the trial and 12 responded to the treatment. Among respondents, reduction in active inflammatory acne lesions was, on average, 50.1% at the end of the 4-week treatment period, 68.5% 4 weeks after the final treatment, and 71.8% 12 weeks after the final treatment. ALA-PDT with IPL activation was well-tolerated by all patients. No treated lesion recurred at the end of the follow-up period. ALA-PDT with IPL activation is a treatment option for patients with moderate to severe inflammatory acne vulgaris.

The successful use of ALA-PDT in the treatment of recalcitrant molluscum contagiosum.

Photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) has been shown to be safe and effective for a variety of skin concerns. The case report described is the first successfully documented use of ALA/PDT in the therapy of recalcitrant molluscum contagiosum in HIV-positive individuals.

ALA-PDT and blue light therapy for hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, often suppurative skin condition which affects primarily apocrine glands. A variety of therapies have been used to treat HS, often with unsatisfactory results. Photodynamic therapy (PDT), utilizing topical 20% 5-aminolevulinic acid (ALA) is being used to treat a variety of dermatologic skin concerns, including photorejuvenation and associated actinic keratoses, and acne vulgaris, and other skin tumors. OBJECTIVE: The purpose of these case reports is to evaluate the effectiveness of ALA-PDT in treating recalcitrant cases of HS. METHODS: Four patients, not responding to standard HS therapy, underwent short-contact ALA-PDT therapy utilizing a blue light for activation. One to two week intervals between therapies was utilized for 3-4 total treatments and follow-up was for 3 months following the last treatment. RESULTS: All four of the patients tolerated the therapies well. Clinical improvements from 75-100% were noted n 11 of the patients. No adverse effects were seen during the treatments. The treatments were pain free and there was no downtime associated with these ALA-PDT treatments. CONCLUSIONS: HS is a chronic disease which most dermatologists find difficult to treat. The use of ALA-PDT is finding an ever-expanding role in dermatology. These case studies support the use of ALA-PDT in cases of HS. Although all advertising material is expected to conform to ethical and medical standards, inclusion in this publication does not constitute a guarantee or endorsement by the Journal or its staff of the quality or value of such products or of the claims of any manufacturer.