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1.
Clin Exp Dermatol ; 39(6): 738-40, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24890518

RESUMO

Tuberous sclerosis (TS) is a genodermatosis characterized by facial angiofibromas (FAs). These tumours cause aesthetic disfigurement and obstruction of vision, and haemorrhage when traumatized, which can lead to emotional distress and relationship difficulties. We report the case of a 35-year-old patient with extensive TS-associated FAs that were treated with an ultrapulse carbon dioxide laser (UPCDL). UPCDL laser seems to be a easy, useful and convenient tool for the treatment of nodular FAs, which provides good aesthetic results, and a positive response from patients, who report high levels of satisfaction with the results. Minimal recurrence of the tumours occurred during long-term follow-up, and these were successfully treated with UPCDL. It is not yet possible to correct the genetic alterations underlying TS, but UPCDL treatment is a convenient tool to improve the facial appearance of patients with severe FAs.


Assuntos
Angiofibroma/cirurgia , Neoplasias Faciais/cirurgia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Neoplasias Cutâneas/cirurgia , Esclerose Tuberosa/complicações , Adulto , Dióxido de Carbono , Humanos , Masculino , Resultado do Tratamento
2.
G Ital Dermatol Venereol ; 143(5): 329-37, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18833074

RESUMO

RESULTS: For over five years, we have been using a new ultraviolet B ray source, a Xenon-Chloride lamp emitting non-coherent, monochromatic 308-nm light that represents the natural evolution of the excimer laser. A source of monochromatic excimer light (MEL) produces 50 mW/cm(2) power density at a distance of 15 cm from the source and has a maximum irradiating area of 504 cm(2), this feature representing the greatest therapeutic advantage offered by 308 nm sources. On the other hand, the benefits offered by the MEL compared to traditional phototherapies are essentially correlated to the fact that there is no need to administer oral psoralens (PUVA therapy) and that sessions need to be repeated only every 7-15 days, an important condition for the improvement of the patient's quality of life (since at least 2-3 weekly sessions are required with the traditional UVB therapy). Using MEL, UV B light can be applied on the entire body, with partial subintrant skin irradiations, or on one or just a few individual patches, taking care to accurately protect the healthy surrounding skin and allowing for a phototherapy exclusively targeted onto the lesion to be treated. Clinical indications and the reasons for choosing MEL for the treatment of photosensitive skin disorders are virtually identical to those stated for PUVA therapy or narrowband UV B light. Due to the absence of photosensitizing substances and drug-induced toxicity, patients who work in the open air, pregnant women and patients suffering from liver or kidney failure can also be treated. Furthermore, the short time required for sessions, the duration of cycles and the selective exposure of the skin areas to be treated undoubtedly represent significant benefits for patients in terms of safety and efficacy. In addition to psoriasis, the use of MEL can also be extended to other pathologies such as vitiligo, alopecia areata, atopic dermatitis and patch-stage IA mycosis fungoides with encouraging


Assuntos
Lasers de Excimer/uso terapêutico , Dermatopatias/radioterapia , Humanos
6.
J Chemother ; 16(5): 491-3, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15565918

RESUMO

Photodynamic therapy (PDT) is a treatment modality using a photosensitizer, light and oxygen to cause photochemically-induced selective cell death. Topical PDT is most suitable for thin lesions such as superficial basal cell carcinoma and actinic keratoses in dermatology. Results with PDT as treatment of thicker lesions such as nodular basal cell carcinoma appear to have a limited role because the photosensitizer or the light cannot penetrate deeply enough into the thicker tumor volume. In this preliminary study we use intralesional administration of 5-aminolevulinic acid to enhance the efficacy of the photosensitivity of nodular basal cell carcinomas, thus improving clinical cure.


Assuntos
Ácido Aminolevulínico/administração & dosagem , Carcinoma Basocelular/tratamento farmacológico , Fármacos Fotossensibilizantes/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Carcinoma Basocelular/patologia , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia , Neoplasias Cutâneas/patologia , Resultado do Tratamento
7.
J Chemother ; 16(3): 306-9, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15330331

RESUMO

The ocular tissues can be the site of a number of malignant tumors in adults. Approximately 5% to 10% of all skin tumors occur in the eyelid. Incidence studies indicate that basal cell carcinoma is the most frequent malignant eyelid tumor (90%) followed by squamous cell carcinoma (9%). A 55-year-old man presented a squamous cell carcinoma (SCC) of 8 mm diameter, localized in the middle third of the lower eyelid, 3 mm under the eyelid margin on the eyelids. The histopathologic examination of a biopsy specimen showed the typical features of squamous cell carcinoma. Photodynamic therapy (PDT) with topical 5-aminolevulic acid (ALA) after Frost suture was employed. Very good results were obtained with rapid healing, without invasiveness, and without anesthesia. There was no evidence of scar formation and no signs of recurrence at 6 months follow-up. Many therapeutic methods have been suggested for squamous cell carcinoma of the eyelid. We consider photodynamic treatment of eyelid skin malignancies to be of great interest and it may represent an interesting future perspective for their management especially when surgical intervention cannot be tolerated by the patient.


Assuntos
Ácido Aminolevulínico/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Neoplasias Palpebrais/tratamento farmacológico , Neoplasias Palpebrais/patologia , Fotoquimioterapia/métodos , Biópsia por Agulha , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Medição de Risco , Resultado do Tratamento
8.
J Eur Acad Dermatol Venereol ; 17(4): 408-13, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12834450

RESUMO

BACKGROUND: Various types of UVB radiation source (290-320 nm) are used in treating psoriasis and their therapeutic mechanism has been attributed to immunosuppressive properties. Recently, a new UVB source generated by a 308-nm excimer laser has been introduced for the treatment of psoriasis. OBJECTIVE: In this study we investigated the immunohistochemical evaluation of T cells and the expression of various apoptosis-related molecules in the psoriatic hyperproliferative skin before and after treatment with 308-nm monochromatic excimer light (MEL). METHODS: Ten patients (three women and seven men), ranging in age from 29 to 79 years, affected by plaque-type psoriasis vulgaris, were treated with MEL. Biopsies from psoriatic lesions of MEL-treated sites were taken before, 24 h and/or 48 h after the first irradiation and analysed by the immunophosphatase alkaline technique (APAAP). RESULTS: MEL treatment was found to cause a significant decrease in the rate of proliferation of keratinocytes and a relevant depletion of T cells in all psoriatic lesions, 48 h after the first irradiation: 308 nm light eliminated T cells from the psoriatic epidermis and also from the dermis, highlighting the ability of this UVB source to penetrate the skin compared with normal UVB and establish direct cytotoxic action on T cells infiltrating skin lesions. Rapid clearing of psoriatic lesions involves potential molecular targets of UVB in T cells including p53, which is upregulated after direct irradiation with 308-nm UVB. Moreover, Bcl-2 expression in healing psoriasis epidermis after MEL treatment is significantly decreased compared with untreated skin and the TUNEL (TdT-mediated dUTP-biotin nick end labelling) technique revealed the presence of relevant apoptotic keratinocytes in the irradiated epidermis. CONCLUSIONS: These results indicate that psoriatic skin after monochromatic excimer light therapy is associated with significant T-cell depletion and alterations of apoptosis-related molecules accompanied by a decreased proliferation index and clinical remission.


Assuntos
Apoptose/efeitos da radiação , Psoríase/patologia , Psoríase/radioterapia , Linfócitos T/efeitos da radiação , Terapia Ultravioleta/métodos , Adulto , Idoso , Biópsia por Agulha , Relação Dose-Resposta à Radiação , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Marcação In Situ das Extremidades Cortadas , Masculino , Pessoa de Meia-Idade , Probabilidade , Estudos Prospectivos , Medição de Risco , Estudos de Amostragem , Pele/citologia , Pele/patologia , Linfócitos T/patologia , Resultado do Tratamento , Raios Ultravioleta
10.
J Chemother ; 13(5): 494-502, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11760213

RESUMO

Photodynamic therapy (PDT) is a treatment modality using a photosensitizer, light and oxygen to cause photochemically induced selective cell death. When exposed to light with the proper wavelength, the topically applied photosensitizer or photosensitizer precursor can activate a biomolecule through electron transfer to yield free radicals or produce singlet oxygen from energy transferred from the excited sensitizer to molecular oxygen. The tissue damage is the result of the activation of reactive singlet oxygen or free radical production. Photodynamic therapy with topical application of 5-aminolevulinic acid (ALA) is a new technique and although it remains largely experimental, it has potential application for treatment of malignant skin tumors, various precancerous and selected benign skin diseases. This technique yields not only a high percentage of good therapeutic results but also excellent cosmetic outcome. This paper reviews the recently published data on clinical ALA-based PDT in dermatology.


Assuntos
Ácido Aminolevulínico/farmacologia , Doença de Bowen/tratamento farmacológico , Carcinoma Basocelular/tratamento farmacológico , Ceratose/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/farmacologia , Neoplasias Cutâneas/tratamento farmacológico , Administração Tópica , Ácido Aminolevulínico/administração & dosagem , Ensaios Clínicos como Assunto , Radicais Livres , Humanos , Fármacos Fotossensibilizantes/administração & dosagem , Lesões Pré-Cancerosas/tratamento farmacológico
11.
J Eur Acad Dermatol Venereol ; 15(6): 559-65, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11843217

RESUMO

BACKGROUND: Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side-effects. OBJECTIVE: This study examines the clinical effects and safety of applications with a 1064-nm Nd:YAG laser system (SmartEpil II, DEKA M.e.l.a., Florence, Italy) to treat vessels on the face and legs. MATERIALS AND METHODS: Twenty-five subjects with facial telangiectasias underwent one treatment at 100 J/cm2, 10 ms and 2 Hz repetition rate. Thirty-two subjects with leg telangiectasias, measuring 0.1-3 mm in diameter, were treated at 125-200 J/cm2, 10-30 ms and 2 Hz repetition rate. Subjects in this group underwent one to five treatment sessions at 8 week intervals. RESULTS: All subjects showed visible improvement, with 95-100% clearing of the face telangiectasias after only one treatment, and 50-100% clearing of the lower extremity vessels after three to five treatments. Transitory hypopigmentation was seen in two cases subjected to leg vessel treatment. CONCLUSIONS: Treatment of facial and leg telangectasias using a true long pulse 1064 nm Nd:YAG laser is an effective and safe method. The relative lack of discomfort combined with a high degree of individual satisfaction should play a part in the fairly high level of acceptance of this new form of therapy for the treatment of leg and face telangiectasias.


Assuntos
Terapia a Laser , Telangiectasia/radioterapia , Adulto , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/radioterapia , Feminino , Seguimentos , Humanos , Dermatoses da Perna/diagnóstico , Dermatoses da Perna/radioterapia , Masculino , Pessoa de Meia-Idade , Neodímio , Índice de Gravidade de Doença , Telangiectasia/diagnóstico , Resultado do Tratamento
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