Herpes simplex virus reactivation after nonablative fractional laser to treat facial photoaging.

Contemporary approaches for facial rejuvenation encompass the utilization of both ablative and nonablative laser techniques. Extensive research has elucidated the adverse consequences associated with ablative laser treatment, such as the emergence of infectious, follicular, scarring, and pigmentary alterations. Nonablative fractional lasers exhibit commendable cosmetic outcomes, characterized by a diminished incidence of complications owing to their photomechanical mechanisms, in contrast to ablative laser modalities. Nonetheless, it is imperative to acknowledge that untoward effects may still manifest. In this report, we present two cases of herpes simplex virus (HSV) reactivation subsequent to nonablative fractional resurfacing. Timely identification and the appropriate administration of antiviral agents are important, which serve as imperative measures to mitigate the long-term consequences that may arise in the event of complications.

Treatment of periorbital aging with negative pressure fractional microneedle radiofrequency: A self-controlled clinical trial.

BACKGROUND: Several treatment modalities are used for the treatment of periorbital rejuvenation with variable results. Recent studies showed that fractional radiofrequency may be an effective treatment modality for periorbital aging. This study aims to determine the efficacy and safety of negative pressure fractional microneedle radiofrequency (NPFMR) as a treatment for periorbital aging. METHODS: Twenty-five patients with periorbital aging were involved in this study. They were treated two times with an interval of 1 month. The patients were evaluated before treatment and 1, 3, and 6 months after the final treatment. RESULTS: The research findings suggest that periorbital wrinkles of the patients were significantly improved by VISIA system (p < 0.05). Physiological indicators detected by MPA10 system showed that compared with before treatment, the hydration increased (p < 0.05) and trans epidermal water loss (TEWL) decreased (p < 0.05) at 3 and 6 months after treatment. The glossiness increased at 1 month after treatment compared to pre-treatment (p < 0.05) and returned to the baseline level at 3 and 6 months after treatment. There was no significant change in melanin content (p > 0.05). Periorbital dermal thickness of the patients significantly increased at 1, 3, and 6 months after treatment according to skin ultrasound (p < 0.05). A periorbital skin biopsy revealed that the collagen fibers in the dermis were significantly thicker and more orderly after treatment, and the expression of type I collagen fibers and elastic fibers was increased compared with that before treatment. One patient developed post-inflammatory hyperpigmentation (PIH) at 1 month after the first treatment, which improved after active treatment. No other adverse reactions were observed. CONCLUSIONS: NPMFR could be an effective and safe treatment modality for the treatment of periorbital aging.

Enhancement of the cytotoxic effect of dihydroartemisinin in high-risk human papillomavirus-infected cells by aminolevulinic acid via the Bax/Bcl-2-caspase pathway.

BACKGROUND: Traditional treatments for human papillomavirus-related cutaneous diseases include 5-aminolevulinic acid photodynamic therapy, cryotherapy, microwave ablation, and surgical resection. These treatment methods involvevarious adverse reactions; therefore, it remains necessary to explore new treatment methods. Dihydroartemisinin shows cytotoxic effects against several malignancies by producing reactive oxygen species, and heme environments reportedly enhance its activity. However, the underlying mechanismsare still unclear. Therefore, we investigated the mechanism of dihydroartemisininin inhuman papillomavirus-infected cells. METHODS: HeLa cells were treated with dihydroartemisinin, 5-aminolevulinic acid, and succinylacetone. The cell viability, apoptosis, mitochondrial membrane potential, and reactive oxygen species levels were investigated, and via western blotting analysis and polymerase chain reaction, dihydroartemisinin activity-related pathways were also determined. RESULTS: Dihydroartemisinin inhibited HeLa cell proliferation and promoted cell apoptosis via the Bax/Bcl-2-Caspase pathway in a concentration-dependent manner. The specific cytotoxicity toward HeLa cells was enhanced by the addition of 5-aminolevulinic acid, a clinically used heme-synthesis precursor, owing to an increase in heme levels. Conversely, following the addition of succinylacetone, a heme synthesis blocker, heme levels decreased. Furthermore, dihydroartemisinin significantly increased reactive oxygen species levels as intracellular heme synthesis increased. Moreover, photodynamic therapy following dihydroartemisinin and 5-aminolevulinic acid treatment further enhanced the cytotoxic effect of dihydroartemisinin on high-risk human papillomavirus-infected cells. CONCLUSIONS: Dihydroartemisinin exerts acytotoxic effect on high-risk human papillomavirus-infected cells by modulating heme levels via the Bax/Bcl-2-Caspase pathway, and the dihydroartemisinin, 5-aminolevulinic acid, photodynamic therapy combination treatment significantly enhanced its cytotoxic effect on human papillomavirus-infected cells.

Effectiveness of photodynamic therapy with 5-aminolevulinic acid for Bowenoid papulosis: A retrospective study with long-term follow-up.

BACKGROUND: Bowenoid papulosis (BP) is a rare infectious skin disease that occurs in sexually active young people. BP is associated with human papillomavirus (HPV)16 and 18 infections, spreads through sexual contact, and tends to become cancerous. Currently, there are different BP treatment methods, and few reports on the efficacy of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) (ALA-PDT). We compared the differences in the clearance and recurrence rates of BP between the ALA-PDT group and other groups, and explored methods to improve clinical effects and reduce lesion recurrence by combining clinical retrospective data. METHODS: We enrolled patients who were diagnosed with bowel papulosis" between January 1, 2009, and December 31, 2020. Patient information, such as ID number, hospitalization number, admission time, name, age, gender, telephone number, admission record, discharge record, outpatient medical history, HPV type analysis, histopathological examination, and treatment plan were recorded. Outcomes were obtained and recorded through outpatient visits, telephone, and online follow-ups from patients who had reached the treatment endpoint. We compared and evaluated the differences in lesion clearance rate, lesion recurrence rate, and patient satisfaction between the ALA-PDT group and other groups using statistical analysis. RESULTS: The lesion clearance rate of the ALA-PDT group was significantly higher than that of the control group, the lesion recurrence rate was lower than that of the control group, and patient satisfaction was higher than that of the control group. The lesion clearance rate of the ALA-PDT group was higher than that of the microwave and radiofrequency groups, the lesion recurrence rate of the ALA-PDT group was significantly lower than that of the microwave and radiofrequency groups, and patient satisfaction was significantly higher than that of the microwave and radiofrequency groups. In the lesions of patients with BP, in addition to HPV16 and HPV18 types, other types were also detected, and most of them were mixed types of HPV infection. Age, sex, and duration of disease were not risk factors that affected BP recurrence. CONCLUSIONS: ALA-PDT for BP has the advantages of high lesion clearance rate, low lesion recurrence rate, and high patient satisfaction. ALA-PDT is worthy of recommendation as a preferred treatment plan for the treatment of BP.

ALA-PDT combined with cystoscopy: A method to eliminate refractory HPV infection in a patient with condyloma acuminata.

BACKGROUND: Condyloma acuminata is a common sexually transmitted disease for which an underlying chronic human papillomavirus (HPV) infection is an important cause of recurrence. 5-aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) has become an effective method to treat condyloma acuminata. Urinary tract condyloma acuminata are not considered common, but warts in the bladder can be detected by cystoscopy. OBJECTIVE: To treat a urinary tract HPV infection in a 35 years old woman diagnosed with condyloma acuminata and to eliminate HPV infection. METHOD: A total of six sessions of ALA-PDT to the cervix and seven sessions of ALA-PDT to the vagina were executed, and the patient subsequently had a cystoscope examination. The wart in the bladder was found by cystoscopy and cauterized with radiofrequency. RESULT: Internal urethra, urethral orifice, cervical, vaginal, and vulvar HPV-DNA detection eventually all returned negative results, and there was no recurrence with two years of follow-up.

Therapeutic evaluation of 5-aminolevulinic acid-mediated photodynamic therapy in Bowenoid papulosis.

BACKGROUND: Bowenoid papulosis is a polymorphic papular disease that occurs on the external genital area. We investigated the efficacy of 5-aminolevulinic acid-mediated photodynamic therapyin the treatment of Bowenoid papulosis. METHODS: We investigated 200 Bowenoid papulosis cases from the Department of Dermatology and Venereology of Nanfang Hospital in 2016-2018. Biopsies were performed from Bowenoid papulosis lesions before treatment. The patients were divided into two groups: 100 patients each in the 5-aminolevulinic acid-mediated photodynamic therapy and control groups(radiofrequency cauterisation, microwave ablation, and surgical resection groups). Differences in lesion clearance, recurrence rate, and patient satisfaction after treatment were evaluated. RESULTS: Photodynamic therapy sessions for multifocal Bowenoid papulosis were more frequent than those for monofocal lesions. All lesions in the 5-aminolevulinic acid-mediated photodynamic therapy group were cleared after photodynamic therapy, with no recurrence at the 1-year follow-up; however, 20 (20.0 %) patients in the control showed recurrence after 1 year. Only 5patients in the photodynamic group were unsatisfied with the treatment cost and 34 patients in the control group experienced short-term pain and scarring. The recurrence rate was significantly lower (P < 0.05) and patient satisfaction was higher (P < 0.05) in the 5-aminolevulinic acid-mediated photodynamic therapy group than those in the control. The recurrence rate was significantly lower (P < 0.05) and patient satisfaction was higher (P < 0.05) in the 5-aminolevulinic acid-mediated photodynamic therapy group than those in the surgical resection group. The recurrence rate of lesions was significantly lower in the surgical resection group than that in the rest of the control group (P < 0.05). There was no difference in recurrence rate and patient satisfaction between the radiofrequency cauterisation and microwave ablation groups. CONCLUSIONS: 5-aminolevulinic acid-mediated photodynamic therapy for Bowenoid papulosis results in a low recurrence rate and high satisfaction.

Evaluation of human papillomavirus DNA detection-guided aminolaevulinic acid-mediated photodynamic therapy for the treatment of condyloma acuminata.

BACKGROUND: Aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) is used to treat condyloma acuminata (CA), yielding a high clearance rate and low recurrence rate. Consecutive human papillomavirus (HPV) DNA detection can be used to dynamically monitor the therapeutic efficiency of PDT. Here, we evaluated the efficacy of ALA-PDT in the context of different HPV infection states. METHODS: One hundred thirty-eight patients with HPV infection and visible anogenital warts were enrolled. Microwave or radiofrequency was used to remove visible lesions before PDT. HPV DNA detection was performed using real-time polymerase chain reaction before each PDT session and at follow-up. Treatment was halted after the patient showed two negative results for HPV DNA detection in a row. RESULTS: Of the 138 patients enrolled in the study, 72 completed treatment. Multisite HPV-infected patients required more sessions of PDT than did single-site infected patients to reach the endpoint of treatment. Compared with patients with only external CA, individuals with internal CA required more sessions to eliminate HPV infection. The total number of PDT sessions performed in the multitype HPV-infected group was significantly higher than that in the single-type infected group. Patients with non-high-risk (HR)-HPV infection required fewer PDT sessions than did those with HR-HPV infection by the end of treatment. Sixty-nine patients were followed-up for at least 6 months, only 2.9% of whom showed recurrence. CONCLUSIONS: Combined ALA-PDT and HPV DNA detection was an effective strategy for the treatment of CA. Patients with multisite and multitype HPV infection required more PDT sessions to eliminate the virus.