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wan and Lin Dovepress Table 1 Comparative studies on PDT light sources in treatment of acne Reference Pinto et al176 2013 Hong et al49 2013 Shaaban et al177 2012 Haedersdal et al178 2008 Sadick179 2010 Barolet and Boucher180 2010 Yeung et al181 2007 Akaraphanth et al103 2007 Rojanamatin and Choawawanich182 2006 Hörfelt et al105 2006 wiegell and wulf106 2006 wiegell and wulf98 2006 Santos et al183 2005 152 N 36 20 30 12 20 10 23 20 14 30 36 15 13 Type of trial; study population/type Prospective, controlled, investigator-blinded; mild- to-moderate acne Split-face, Fitzpatrick skin phototypes Iv–v Controlled; nodulocystic and inflammatory acne vulgaris on face and back Split-face, randomized, controlled; Fitzpatrick skin type I–III, inflammatory lesions Split-face, randomized; moderate-to-severe acne Split-face/back; randomized, controlled, investigator-blinded Split-face, randomized, single-blind; Fitzpatrick skin phototypes Iv or v, moderate acne Split-face; moderate- to-severe acne Split-face Split-face; blinded, prospective, randomized, placebo-controlled; moderate-to-severe acne Randomized, controlled, investigator-blinded Split-face; randomized, controlled, investigator- blinded Split-face; I and NI lesions Light source (dose); incubation time MAL-PDT versus red light (average wavelength 635 nm, light dose 37 J/cm2, fluence rate approximately 70 mw/cm2) alone; 90 minutes MAL-PDT + red light (22 J/cm2 and fluence rate was 34 mw/cm2) versus IPL (530–750 nm; fluence 8–10 J/cm2) IL-ALA versus IPL (560 nm, fluence 26 J/cm2, 15 msec pulse, 2–3 passes) alone; 30 minutes MAL-LPDL versus LPDL (595 nm, 7.5 J/cm2, 10 msec, 2 passes); 3 hours ALA-KTP versus KTP (532 nm) only Pretreatment with infrared LeD (970 nm) and ALA- PDT + LeD (630 nm) versus LeD (630 nm) only 16% MAL-IPL versus IPL (530–750 nm, double pulses, 2.5 msec) only versus placebo; 30 minutes 10% ALA-PDT versus blue light (415 nm, 40 mw/cm2, 48 J/cm2); 1 hour 20% ALA-IPL versus IPL (560–590 nm, 25–30 J/cm2, double pulse) only; 30 minutes 16.8% MAL-PDT versus placebo; 3 hours 16.8% MAL-PDT versus placebo; 3 hours 20% ALA-PDT versus 16.8% MAL-PDT; both with red light (630 nm, 37 mw/cm2, 34 J/cm2); 3 hours 20% ALA-IPL versus IPL (560 nm, 26 J/cm2, double pulse) alone; 3 hours Session number (interval); follow-up 2× (2 weeks); 10 weeks 3× (2 weeks); 4 weeks 3× (1 week); 1 month 3× (2 weeks); 12 weeks 3× (4 weeks) Once; 4 weeks 4× (3 weeks); 12 weeks 4× (1 week); 16 weeks 3× (3–4 weeks); 12 weeks 2× (2 weeks); 10 weeks 2× (2 weeks); 12 weeks Once; 12 weeks 2× (2 weeks); 8 weeks Results MAL-PDT . red light alone: greater and more rapid clinical and histologic responses in MAL-PDT than red light only group. Histologically, decreased amount of sebocytes, lipids, and atrophic sebaceous glands. week 10, MAL-PDT (100%), red light only (77.7%) achieved successful treatment. MAL-PDT + red light produced a more rapid response in I and NI lesions than IPL, but both had satisfactory results. Decrease fluence for Fitzpatrick skin type Iv–v given increased risk of postinflammatory hyperpigmentation. IL-ALA . IPL alone: inflammatory lesion count was less in IL-ALA. Recurrence after 1 month: 16.67% IL-ALA, 100% IPL only. MAL-LPDL . LPDL alone but not powered to study efficacy of LPDL alone; median reduction of inflammatory lesions: 80% MAL-LPDL, 67% LPDL. Improvement in acne: 52% ALA-KTP, 32% KTP. Inflammatory lesion reduction: 73% IR + ALA-PDT + LeD, 38% LeD. Improvement in clinical severity and reduction of NI lesions with IR + ALA-PDT (P=0.027 and P=0.037, respectively). Control . MAL-IPL . IPL only: reduction of inflammatory lesions: 88% control, 65% MAL-IPL, 23% IPL (not significant). Reduction of noninflammatory lesions: 38% MAL-IPL (P=0.05), 44% IPL (P=0.01); 15% increase in control group (P=0.36). Reduction of inflammatory lesions: 71.1% ALA-PDT, 56.7% blue light alone (not significant). No significant difference in lipid level. Reduced lesion count 87.7% ALA-IPL, 66.8% IPL only (difference not significant). M AL-PD T . placebo: inflammatory lesion reduction: 54% MAL-PDT, 20% placebo. Difference in NI lesions not significant. MAL-PDT . placebo: inflammatory lesion reduction: 68% MAL-PDT, 0% control. No improvement in NI lesions. A 59% decrease in inflammatory lesions but no significant difference between MAL and ALA. ALA-IPL . IPL alone: ALA-IPL visible improvement (76.9%), IPL alone returned to baseline of facial acne. submit your manuscript | www.dovepress.com Dovepress (Continued) Clinical, Cosmetic and Investigational Dermatology 2014:7PDF Image | applications of photodynamic therapy dermatology
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