Efficiency of photodynamic therapy in the correction of postacne scars and morphofunctional changes in the skin

Clinical observation of a patient with an orphan disease (mucinous peritoneal carcinomatosis) after 2 courses of intraoperative photodynamic therapy with photogem photosensitizer is presented. During the first course of photodynamic therapy, photogem was administered at a dose of 2.5 mg/kg, the energy density of the laser radiation was 10 J/cm2. The duration of stabilization after the first course of treatment was 2 years, after which the progression of the disease was registered. The second course of photodynamic therapy was carried out in the same way. The duration of stabilization after the first course of treatment was 2.5 years. The patient died as a result of an accident unrelated to the disease.

In recent years, there has been a growing interest in the use of dental lasers for treatment of periodontal diseases. The purpose of this short-term clinical trial was to evaluate the effects of a combination of photodynamic therapy with low-level laser therapy as an adjunct to nonsurgical treatment of chronic periodontitis. Twenty-four nonsmoking adults with untreated chronic periodontitis were randomly assigned in a split-mouth design to receive scaling and root debridement with or without one course of adjunctive photodynamic therapy and low-level laser therapy within 5 d. Plaque, bleeding on probing, probing depth and gingival recession were recorded at baseline, 1 and 3 mo after the treatment. Gingival crevicular fluid was collected for assay of interleukin-1β levels at baseline, 1 wk and 1 mo. The test teeth achieved greater reductions in the percentage of sites with bleeding on probing and in mean probing depth at 1 mo compared with the control teeth (p < 0.05). A significant decrease in gingival crevicular fluid volume was observed in both groups at 1 wk (p < 0.001), with a further decrease at 1 mo in the test sites (p < 0.05). The test sites showed a greater reduction of interleukin-1β levels in gingival crevicular fluid at 1 wk than the control sites (p < 0.05). No significant differences in periodontal parameters were found between the test and control teeth at 3 mo. The present study suggests that a combined course of photodynamic therapy with low-level laser therapy could be a beneficial adjunct to nonsurgical treatment of chronic periodontitis on a short-term basis. Further studies are required to assess the long-term effectiveness of the combination of photodynamic therapy with low-level laser therapy as an adjunct in nonsurgical treatment of periodontitis.

The results of 4-year clinical follow-up in the patient with obstructive inoperable retropericardial esophageal cancer are represented. According to cardiac co-morbidity (myocardial infarction, postinfarction cardiosclerosis) the palliative care for patient was managed. To preserve patency of esophagus multiple courses of endoscopic photodynamic therapy by means of the approach developed in P.A. Herzen MCRI were performed. From 2011 to 2014 thirteen courses of photodynamic therapy with photosens were conducted. The patient was under follow-up for 4 years and 3 months to his death in 2015. For follow-up period the patient had oral feeding with no signs of dysphagia, not significant weight loss and with good quality of life.

Results of clinical follow-up of the patient with squamous cell skin carcinoma of the nasal dorsum are represented. The patient underwent a course of combined photodynamic therapy (PDT) with distant gamma-ray therapy. Distant gamma-ray therapy was performed daily during 12 days (single dose of 3 Gy, total dose of 36 Gy) with the first session 24 h after injection of the photosensitization. For PDT the photosensitizer photosens at dose of 0,3 mg/kg was used. The method of prolonged PDT was applied, sessions of laser irradiation were performed daily during 7 days. The PDT sessions were carried out 2 h after session of gamma-ray therapy using distant (150 J/cm 2 , 40 mW/cm 2 ) and contact (500 J/cm 2 , 100 mW/cm 2 ) modalities. According to multiple cytological studies after treatment there were no signs of tumor, but inflammation. Four months after treatment according to cytological data continued tumor growth was detected. The patient underwent an additional course of PDT. Currently the patient is under follow-up: no recurrence during 8 months after repeated treatment.

To describe the deficits in four electroretinography (ERG) modalities in patients with neovascular age-related macular degeneration (AMD). To describe the changes in these parameters during a course of verteporfin photodynamic therapy (PDT). Pattern (PERG), multifocal (mfERG) (19 segment simplified test protocol), flash ERG and flicker ERG were performed in patients with active neovascular AMD before PDT and compared to fellow eye controls using paired t-tests. Changes in ERG parameters during the 12 month treatment course were visualised using 95% confidence intervals of the median difference. The statistical significance of any changes was quantified using Wilcoxon signed ranks tests. Fifty patients were recruited and followed. At presentation all ERG amplitudes were reduced with greater reductions in focal as opposed to global test protocols (P < 0.05). Over the 12 month course of PDT, PERG P50 amplitude showed a general downward trend and latency remained unchanged. mfERG p1 amplitude density showed an upward trend at six months before returning to baseline by 12 months. mfERG ring 2 amplitude density was significantly increased at 12 months compared to baseline (P = 0.010). Flicker ERG latency was significantly increased at six months compared to baseline (P = 0.015). The simplified mfERG protocol was tolerated by this patient group, however, they found the full test protocol demanding. Large deficits in the retinal ERG function occur in neovascular AMD and involve retinal locations adjacent to as well as overlying choroidal neovascularisation (CNV). After PDT there is an improvement in electro-retinal function in retinal locations overlying the CNV.

The article presents a clinical case of successful elimination of mechanical jaundice by means of a course of photodynamic therapy in a patient with a malignant neoplasm of the major duodenal papilla and multimorbid concomitant pathology. The patient, admitted with a clinical picture of mechanical jaundice, after additional examination was given a final diagnosis - moderately differentiated adenocarcinoma of the major duodenal papilla, stage IIa (T2N0M0), complicated by moderate mechanical jaundice. After primary stenting, a series of three consecutive courses of combined systemic and local photodynamic therapy were performed with a three-month interval between them. During the last course, stent migration into the duodenum was detected. Nevertheless, the complex therapy allowed to effectively eliminate the manifestations of mechanical jaundice, stabilize the patient's condition, prevent further growth of the primary tumor, restore the patency of the ducts of the major duodenal papilla and avoid relapses of mechanical jaundice, despite the migration of the stent. This experience demonstrates the promise of the photodynamic approach for solving complex clinical situations associated with tumor damage to the biliary system and allows to consider this method as an alternative in situations of high risk of complications of traditional surgery.

Psoriasis is a systemic chronic inflammatory disease that affects in the first place the skin and occurs in 1-5% of the general population. The treatment of the patients presenting with this condition implies the application of the topical agent and biological preparations as well as phototherapy and systemic therapy. The patients suffering severe forms of psoriasis in whom systemic immunosuppressive therapy does not yield the desired effect are in need of the treatment with biological preparations. The use of the inhibitors of tumour necrosis factor-alpha produces the insufficient effect even in the case of the positive response, i.e. the psoriasis area and severity index (PASI) of approximately 50 scores (PASI 50). This article presents the results of the application of photodynamic therapy (PDT) for the treatment of 8 patients treated with the inhibitors of tumour necrosis factor-alpha in whom the PASI value of 50 was achieved within the first week after the onset of the treatment. In all these patients, a course of photodynamic therapy consisting of 2-3 procedures made it possible to increase the PASI values to 75 and even 100 scores. It is concluded that the patients showing positive but insufficient effect of biological therapy (PASI 50) need to be prescribed a course of photodynamic treatment in order to enhance the effectiveness of the biological therapeutic factors.

A review of the use of combination therapies for the treatment of acne vulgaris

Acne is a very common dermatosis with characteristic clinical features. It is a polymorphic disease. The clinical expression ranges from non-inflammatory closed and open comedones to inflammatory papules, pustules, and nodules. Most patients have a mixture of non-inflammatory and inflammatory lesions, although some have predominantly one or the other. Acne varies in severity from a very distressing, socially disabling disorder to a state that has been regarded as physiological by some authors. The most severe forms of acne are acne fulminans and acne inversa. Although acne may occur in all age groups, it is most prevalent during adolescence. It is not known why acne subsides in most patients but persists into adulthood in some. Certain medications may be associated with provocation, perpetuation, or exacerbation of pre-existing acne or with acneiform eruptions. Acne-like disorders include rosacea, pseudofolliculitis barbae, and other conditions that share clinical features with acne.

Estimation of blood microcirculation in integuments by non-invasive speckle-optical method under the photodynamic action

Acne is a common inflammatory disorder that can occur in both adolescents and adults. Isotretinoin is used in severe forms of acne which are resistant to adequate courses of therapy with systemic antibacterials and topical solutions. It has a serious side-effect profile and is associated with a number of significant cautions and contraindications. Therefore, isotretinoin should only be prescribed by or under the supervision of physicians with both expertise in the use of systemic retinoids for the treatment of severe acne and a full understanding of the risks of isotretinoin therapy and its monitoring requirements. Isotretinoin is highly teratogenic and is therefore contraindicated in pregnancy. Oral isotretinoin causes increased skin fragility and can result in scarring, and therefore, its summary of product characteristics recommends that wax epilation, laser skin treatment and microdermabrasion should be avoided during and for at least 6 months after treatment. Thorough patient medical history records should be taken and close monitoring is required owing to the effects of isotretinoin on mental function, serum lipid levels and hepatobiliary function.

Purpose. To analyze quality of life dynamics of patients with trophic venous ulcers of the lower limbs after the treatment with the use of photodynamic therapy. Materials and methods. Quality of life research was conducted in 57 patients with trophic ulcers of venous etiology. The first group included 30 patients who received standard treatment, the second group — 27 patients, in which standard treatment was combined with a course of photodynamic therapy. To assess the quality of life of the patients in both groups, a questionnaire was conducted using the EuroQol-5D-5L survey system and the visual analogue scale EQ-VAS. The quality of life assessment was carried out at the beginning of treatment, 10 days and 6 weeks after starting treatment. Results. The results indicate a significant improvement in the quality of life in both groups, but the degree of improvement in this indicator in group 2 was 20.7 % higher.An analysis of the dynamics of improvement in quality of life showed an increase in the mean of the indicator 10 days after the beginning of treatment in patients in the first group of 26.7 %, the second group by 43 %, and in 6 weeks, its increase was achieved in patients in the first group by 32.7 %, in the second group — by 53.4 %. Conclusions. The use of photodynamic therapy in the treatment of venous trophic ulcers significantly affects the quality of life, which is manifested in the anti-inflammatory effect and reduction of pain syndrome in the shorter term (by 76.2 %), compared with patients in the first group.

Goal: evaluation of the efficacy and safety of acnecutan in patients with severe forms of acne or if other acne treatment methods prove to be inefficient. Materials and methods: the study involved 35 patients with severe forms of acne and acne resistant to other therapies. The patients received a monotherapy with acnecutan. The efficacy and safety of this therapy were evaluated at each visit judging by the clinical picture of the disease; the severity of the disease was defined based on the count of components (such as comedones, papulopustules, nodes, dyschromias and scars). The safety of the drug was assessed based on the data on adverse and unforeseen events taking into account subjective (patient’s complaints) and objective (total blood count, urine test, blood biochemistry) indices. Results: against the background of the course of treatment with acnecutan, all patients who participated in the study clinical achieved remission. Conclusion: acnecutan is a highly efficient drug for the treatment of severe forms of acne or acne resistant to other treatments.

A case of successful photodynamic therapy of residual laryngeal tumor after external beam radiotherapy (EBRT) is reported. The female patient with diagnosis of laryngeal cancer T1N0M0 underwent a course of EBRT on larynx, fraction dose = 2 Gy, 5 fractions per week, total radiation dose = 60 Gy. One month after EBRT the continued growth of residual tumor in the left vocal fold was diagnosed. The patient had 4 courses of photodynamic therapy with photosensitizer fotoditazin at a dose of 100 mg combined with electroresection of residual laryngeal tumor. The control video-assisted laryngoscopy 1 month after the 4th course of photodynamic therapy showed that larynx was flexible, vocal function was fully restored, tumor of the left vocal fold wasn’t detected. Non-recurrence follow-up period is 10 month. The patient is under follow-up.

A 33-year-old male great hornbill (Buceros bicornis) presented with a roughened fissured rostral casque. Physical examination revealed a softened rostral casque and diagnostic tests indicated a squamous cell carcinoma. A course of photodynamic therapy was begun in which cytotoxic oxygen radicals were generated to destroy tumor cells. Two courses of photodynamic therapy reduced the size and spread of the tumor initially but failed to eliminate the cancer. Upon physical deterioration and progression of the neoplasia, the bird was euthanized.