Clearance Of Lesions Research Articles

A Case of Placental Implantation with Exaggerated Placental Site

Objective: This study aims to investigate the clinical symptoms, diagnosis, differential diagnosis, and prognosis of exaggerated placental site (EPS), in order to reduce misdiagnosis and missed diagnosis of EPS, avoid the occurrence of serious complications such as massive hemorrhage, and provide some references for clinical doctors. Methods: Retrospective analysis of the medical history and treatment of a patient with placental implantation with exaggerated placental site. A 23-year-old female presented with persistent vaginal bleeding after medical abortion. She was diagnosed with retained products of conception and underwent hysteroscopic surgery. The preliminary postoperative pathological results indicate the possibility of EPS and placental site trophoblastic tumor (PSTT). Further immunohistochemical testing was performed, and the results suggested EPS. Results: The patient recovered well after surgery and did not require further treatment. Her serum human chorionic gonadotropin levels and transvaginal ultrasound findings were normal. Conclusion: EPS is a benign disease, and symptoms will disappear after lesion clearance, requiring no special treatment or follow-up, with a good prognosis. Due to the low incidence rate, atypical clinical symptoms, and insufficient recognition by clinical doctors, EPS are prone to misdiagnosis and missed diagnosis, leading to serious consequences such as massive hemorrhage and hysterectomy. EPS should be considered as a possible diagnosis in any woman who has irregular bleeding following medical abortion.

Intense pulsed light versus pulsed dye laser in the treatment of nail psoriasis: Intra-patient left to right comparative controlled study.

Background Until now, the management of psoriatic nails has not been satisfactory. Pulsed dye laser (PDL) as well as intense pulsed light (IPL) have been evaluated separately for the management of psoriatic nails and proved to be effective. Aim This study aimed to measure and compare the usefulness as well as the safety of intense pulsed light versus pulsed dye laser for the management of psoriatic nails. Methods The psoriatic fingernails of 20 patients were managed using intense pulsed light on one hand and pulsed dye laser on the other. Two to three psoriatic nails were left without treatment as controls. The therapeutic sessions were conducted monthly for a period of 6 months. Evaluation of the clinical outcomes was assessed by a blinded dermatologist depending on the total, nail bed, nail matrix, modified and target NAPSI scores. Patient global assessment, in addition to Nail Psoriasis Quality of Life (NPQL10), was performed to assess the response to the therapy. Results A significant reduction in the total, target and modified NAPSI scores from baseline to the end of the study was detected, but no significant differences were detected between the two treatments. The responses of the nail matrix and bed lesions to both modalities were nearly the same. All patients stated that the two devices were efficient and improved their quality of life. The intense pulsed light treatment was more painful. Complete clearance of nail lesions was not obtained. Limitations Lack of long-term follow-up of cases and preset laser parameters were the major limitations of this study. Conclusion Intense pulsed light, like pulsed dye laser, is safe and efficient in treating nail psoriasis; however, the former is more painful. Dermoscopy had an additive function in analysing the response of nail psoriasis to therapy.

Modified Painless Photodynamic Therapy for Actinic Keratosis in China

SignificanceAminolevulinic acid photodynamic therapy (ALA-PDT) is an effective treatment for actinic keratosis (AK). However, the pain during illumination usually caused patient to discontinue PDT treatment and resulted lower efficacy. Previous study showed modified painless PDT (M-PDT) with short ALA incubation time and longer irradiation time can reduce pain and preserve the efficacy. If M-PDT worked in AK still need to investigate. ApproachA splie-face controlled clinical study was conducted. Eleven patients with facial AK received C-PDT (conventional PDT) on the left and M-PDT in the contralateral area. The left area was illuminated by a red LED light (a total light dose of 140 J/cm2) after applying the ALA cream for 3 hours; the other had illumination for a total light dose of 288 J/cm2 after applying the ALA cream for 0.5 hours. The primary endpoint was the lesion clearance rate at 1 month. Secondary endpoints included pain scores, the incidence of adverse events, and cosmetic outcomes. ResultsAt one month following 3 treatments, the lesion clearance rate of M-PDT was non-inferior to that of C-PDT (93.1% vs. 86.4%, respectively. The lesion clearance rate of M-PDT to reach 100% clearance earlier than C-PDT for grade I lesions and higher clearance rates for grade III lesions. Moreover, the pain score during illumination was significantly lower for M-PDT than for C-PDT (P < 0.01). Regarding photoaging, the Global Subjective Skin Aging Assessment (GS2A2) score showed that the total and atrophy scores of C-PDT and M-PDT were significantly improved, and M-PDT also reduced discoloration. There was no significant difference in adverse reactions between C-PDT and M-PDT. ConclusionsM-PDT is non-inferior to C-PDT in terms of efficacy for treating AK, resulting in much lower pain scores.

Combination of 5-fluorouracil with photodynamic therapy enhances immune responses in a murine model of actinic keratosis

SignificancePhotodynamic therapy (PDT) to treat actinic keratoses (AK) involves application of a photosensitizer followed by exposure to light, resulting in effective lesion clearance by inducing cell death and long-term immune responses. Here, we show that pretreatment of AK lesions with 5-fluorouracil (5FU) causes significant enhancement of PDT-related immune effects. ApproachSKH-1 mice with AK (generated by repeated UVB exposure) were treated topically with 5FU for three days prior to application of topical ALA followed by blue light exposure. AK lesions were harvested for time-course analyses of intra-tumoral immune responses after PDT with or without 5FU. ResultsImmunofluorescence data showed that 5FU pretreatment increased recruitment of innate immune cells, infiltration of activated T cells and of cytotoxic T cells and reduced the presence of cells expressing the immune checkpoint marker PD1. ConclusionsOur results suggest that a combination of 5FU and PDT may synergize to provide better management of AK in the dermatology clinic.

Real-world efficacy of 2% crisaborole ointment on chronic hyperplasia lesions in 49 patients with atopic dermatitis.

Crisaborole, as a phosphodiesterase 4 (PDE4) inhibitor (PDE4i), effectively inhibits inflammatory pathways, showing promising results in atopic dermatitis (AD), particularly in chronic hyperplasia lesions. Based on real-world data from China, this study assesses the effectiveness and safety of 2% PDE4i ointment as monotherapy for chronic hyperplastic AD lesions. A total of 49 AD patients aged 12 and above with chronic hyperplastic lesions and Investigator's Static Global Assessment scores of mild or moderate were enrolled. They received 2% PDE4i ointment twice daily until the lesions completely cleared. The effectiveness endpoints comprised the onset time of pruritus and lesion remission and the time of complete lesion clearance. PDE4i demonstrated high effectiveness with minimal irritation, notable improvement in hyperpigmentation, and early remission of pruritus and lesions. The response varied across age groups; elderly patients experienced quicker pruritus relief compared to adolescents and adults, while adolescents showed earlier lesion remission by about 3 days. No significant difference was observed across age groups in the time for complete lesion clearance. Additionally, AD duration (less or more than 3 years) did not significantly impact pruritus or lesion remission. PDE4i monotherapy is effective and safe for chronic hyperplasia lesions in AD across all age groups, and its effectiveness appears to be independent of AD duration.

Melanoma-associated melanocortin 1 receptor variants confer redox signaling-dependent protection against oxidative DNA damage

Cutaneous melanoma, a lethal skin cancer, arises from malignant transformation of melanocytes. Solar ultraviolet radiation (UVR) is a major environmental risk factor for melanoma since its interaction with the skin generates DNA damage, either directly or indirectly via oxidative stress. Pheomelanin pigments exacerbate oxidative stress in melanocytes by UVR-dependent and independent mechanisms. Thus, oxidative stress is considered to contribute to melanomagenesis, particularly in people with pheomelanic pigmentation. The melanocortin 1 receptor gene (MC1R) is a major melanoma susceptibility gene. Frequent MC1R variants (varMC1R) associated with fair skin and red or yellow hair color display hypomorphic signaling to the cAMP pathway and are associated with higher melanoma risk. This association is thought to be due to production of photosensitizing pheomelanins as well as deficient induction of DNA damage repair downstream of varMC1R. However, the data on modulation of oxidative DNA damage repair by MC1R remain scarce. We recently demonstrated that varMC1R accelerates clearance of reactive oxygen species (ROS)-induced DNA strand breaks in an AKT-dependent manner. Here we show that varMC1R also protects against ROS-dependent formation of 8-oxodG, the most frequent oxidative DNA lesion. Since the base excision repair (BER) pathway mediates clearance of these DNA lesions, we analyzed induction of BER enzymes in human melanoma cells of varMC1R genotype. Agonist-mediated activation of both wildtype (wtMC1R) and varMC1R significantly induced OGG and APE-1/Ref1, the rate-limiting BER enzymes responsible for repair of 8-oxodG. Moreover, we found that NADPH oxidase (NOX)-dependent generation of ROS was responsible for AKT activation and oxidative DNA damage repair downstream of varMC1R. These observations provide a better understanding of the functional properties of melanoma-associated MC1R alleles and may be useful for the rational development of strategies to correct defective varMC1R responses for efficient photoprotection and melanoma prevention in fair-skinned individuals.

Selection of treatment strategies for lumbar Brucella spondylitis: a retrospective clinical study.

This study aims to investigate the treatment strategies for lumbar brucellar spondylitis by comparing the outcomes of pure pharmacological treatment with diseased intervertebral fixation fusion, with or without lesion clearance. A total of 157 patients with lumbar brucellar spondylitis were categorized into three groups: Group A (52 cases) received pure pharmacological treatment, Group B (53 cases) underwent posterior vertebral fixation fusion, and Group C (52 cases) received posterior (or anterior) lesion clearance followed by posterior vertebral fixation fusion. Clinical data were analyzed, and the efficacy of the three treatment methods was evaluated. The surgical groups showed better outcomes at various time points compared to the pharmacological treatment group (P < 0.05). The pure fixation group outperformed the lesion clearance fusion group during the perioperative period (P < 0.05). The ESR, CRP, ODI scores, imaging evaluation and complications of the lesion clearance followed by fixation group were all better than those of the other two groups (P < 0.05). Surgical treatment groups showed no statistically significant difference in VAS scores (P > 0.05), and both were superior to the pharmacological treatment group. There were no statistically significant differences in clinical efficacy among the three groups at the last follow-up. Surgical treatment achieves early recovery goals compared to pharmacological treatment for brucellar spondylitis. However, individualized treatment principles should guide surgical decisions to select the most suitable approach for patients.

Efficacy and Safety of Q-Switched 1064/532 nm Nd:YAG Lasers on Benign Hypermelanosis in Dark-Skinned Individuals-A Preliminary Study.

Background: Facial hypermelanosis is a major cosmetic issue that causes severe social embarrassment and psychological pain, particularly among Asians and dark-skinned individuals. Aim: This study assesses the safety and effectiveness of Q-switched 1064/532 nm nanosecond/picosecond lasers in removing benign hypermelanosis in dark-skinned individuals, evaluating the possible associated side effects. Material and methods: A total of 30 participants (80% females and 20% males) with Fitzpatrick skin types IV-V-VI who presented superficial benign hypermelanoses on the facial and décolleté area were enrolled. All patients underwent to one to two laser treatment sessions with a 1064/532 nm Q-switched laser system. Three months after the final laser session, results were assessed by comparing before- and after-treatment photos and using a quartile scale for lesion clearance (4-point Investigator Global Assessment scale). Results: All patients observed global improvements in their pigmented lesions: 53% of patients achieved excellent clearance, 30% of patients achieved good to moderate clearance, 10% of patients achieved slight clearance, and 7% of patients did not respond to the therapy. No serious adverse event occurred. Photos showed the clinical improvement achieved at 3 months follow-up. Conclusions: The Q-switched 1064/532 nm laser proved to be a key tool for treating benign hypermelanosis in all skin types, including dark-skinned persons.

Home- vs clinic-based daylight photodynamic therapy with 5-aminolevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis: A randomized, single-blind, prospective study

BackgroundDaylight photodynamic therapy (DL-PDT) has become one of the most effective treatments for the resolution of actinic keratosis (AK) of Olsen grade 1 and 2. Generally, PDT it is carried out in a clinic setting, which involves the patient's and their caregivers commuting to the hospital as well as a significant use of resources to carry it out within the clinic setting. ObjectivesTo determine the efficacy and safety of a home-based treatment of AK with DL-PDT with the BF-200 ALA gel compared to a clinic-based setting. MethodsThe study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. 9 patients received one clinic-based DL-PDT (group 1) and 11 patients received one session of home-based DL-PDT (group 2). The primary endpoints were the mean AK clearance per patient and the total AK lesion clearance rate 12 weeks after treatment. The secondary endpoints were the number of remaining AKs and new AKs appearing in the treatment field 12 weeks after one PDT session. The pain during and 24 h after PDT as well as the local skin reactions were also assessed. ResultsThe overall reduction of AK lesions per patient was similar in both groups with one PDT session. An overall AK clearance per patient of 10 ± 4.33 for group 1 versus 9.73 ± 2.9 for group 2 without statistically significant differences (p = 0.868). Regarding the clearance rate, although it was slightly higher in group 2 (71.58 ± 22.51 vs 82.1 ± 11.13), the analysis did not show statistically significant differences. The mild pain recorded during the treatment course and the mild local skin reactions were similar in both groups. Patient satisfaction was high for both groups without statistically significant differences. ConclusionSelf-performed home-based DL-PDT with BF-200 ALA gel is as effective as the one performed in a clinic-based setting, with a comparable safety profile, high levels of patient satisfaction and with advantages for the patients and their caregivers that can enhance patient´s adherence to the treatment

Berdazimer gel for molluscum contagiosum in patients with atopic dermatitis.

Controlling molluscum contagiosum (MC) infections is critical in atopic dermatitis (AD) management. This post hoc analysis assessed the efficacy and safety of berdazimer gel, 10.3% (topical, antiviral, nitric oxide-releasing medication) versus vehicle in MC patients with or without AD. Three Phase 3, multicenter, randomized, double-blind, vehicle-controlled, parallel-group trials (B-SIMPLE[berdazimer sodium in molluscum patients with lesions]1, -2, -4) enrolled patients 6 months and older with 3-70 mollusca. Berdazimer or vehicle was applied once daily to all MC lesions for 12 weeks. Data from three Phase 3 studies were integrated for subgroup efficacy and safety assessments using several weighted meta-analysis approaches. Patients with concurrent AD or a history of AD/eczema were categorized as AD+ subgroup (AD- when absent). Primary efficacy endpoint: complete lesion clearance at Week 12. Safety endpoints included adverse events (AEs) through Week 24 and local skin reactions through Week 12. Of 1598 enrolled patients, 209 (13.1%) were AD+. Baseline mean lesion counts were greater in AD+ (26.4) than AD- (19.3). Complete clearance rates were higher at Week 12 for berdazimer compared with vehicle in AD+ (n = 209; 35.0% vs. 27.4%; odds ratio [OR], 1.3; 95% CI, 0.7-2.5) and AD- (n = 1389; 29.1% vs. 18.9%; OR 1.8; 95% CI 1.4-2.4) subgroups. AEs in AD+ were application-site pain (21.6% with berdazimer vs. 11.9% with vehicle), dermatitis (12.8% vs. 2.4%), and erythema (9.6% vs. 7.1%). Berdazimer gel showed favorable efficacy regardless of AD status. Berdazimer-induced erythema may be indistinguishable from AD symptoms or with inflammatory response upon resolution of molluscum.

Interventional and device treatment of the periocular area

Growth in the research, innovation, and development of laser and energy-based technologies over the past few decades has led to dramatic increases in treatment options for dermatologic and cosmetic concerns of the periorbital area. We highlight recent treatment options using laser and energy-based devices for the clearance of periocular pigmented lesions, including solar lentigines and nevus of Ota; vascular lesions, including port-wine birthmarks, infantile hemangiomas, superficial telangiectasias, and reticular veins; laser ablation of benign tumors, such as xanthelasma; cosmetic rejuvenation; treatment of infraorbital dark circles and festoons; laser removal of eyebrow and eyeliner tattoos; and device-based treatment of chronic dry eyes.

Mpox Virus in the Pharynx of Men Having Sex with Men: A Case Series.

The recent Mpox virus (MPV) outbreak in Europe and North America, primarily among men who have sex with men (MSM), raised concerns about various transmission sources. We examined patients with Mpox from an urban STI center in Lombardy, Italy, between May and August 2022. Demographic, transmission, and clinical data were collected using a standardized form. Initial and subsequent tests were conducted using the RealStar Orthopoxvirus PCR Kit 1.0 (Altona Diagnostics, Hamburg, Germany) for skin lesions and oropharyngeal swabs. A total of 15 patients were recruited, all MSM, with 40% being HIV-positive. Almost all reported recent unprotected sexual activity. Oropharyngeal symptoms were observed in a minority, and oral cavity lesions were present in 20% of cases. MPV DNA was detected in skin lesions of 93% of patients and in oropharyngeal swabs of 87%. Skin samples exhibited a higher viral load than pharyngeal samples, with the latter persisting longer. Prospective follow-up of 11 individuals revealed an average pharyngeal persistence of 5.3 days beyond skin lesion clearance, reaching up to 80 days in an immunosuppressed case. Our findings indicate that MPV replication can persist in the pharynx asymptomatically and for an extended period.

Topical Therapies of Pyogenic Granuloma in Children: A Systematic Review of Case Reports, Case Series, and Cohort Studies

Abstract Pyogenic granuloma (PG) is a benign vascular tumor removed surgically or by physical modalities, such as electrocautery and cryotherapy. Other treatment options may be warranted, especially in children, using nonsurgical approach. The study aims to determine the effectiveness and safety of topical treatments on PG in children in the clearance of lesions. Systematic literature search were done in February 2023 in the following database: PubMed, HERDIN, Cochrane Library, Hindawi, Directory of Open Access Journals, ScienceDirect, and Google Scholar. The search included studies involving PG treated with topical medications in the pediatric age group. Twenty-five studies (9 cohort studies, 6 case series, and 10 case reports) were included and utilized the following medications: timolol, propranolol, corticosteroids, common table salt, imiquimod, and ingenol mebutate. Among the medications, timolol was the most reported drug to provide partial to complete resolution in 62 out of 149 patients. All the reviewed topical medications provided partial to complete resolution with minimal adverse effects. Among them, topical timolol, propranolol, and table salt have demonstrated high response rates. Topical therapy in children with PG may be considered as a nonsurgical option. However, further clinical trials are warranted to determine its effectiveness.

Perceptions, Utilization, and Cost Assessment of Sebaceous Hyperplasia Treatment Modalities: A Pilot Survey.

Sebaceous hyperplasia (SH) is a common, benign but cosmetically bothersome skin condition preferentially affecting older adults. Despite multiple treatment options, there is no universally accepted first-line treatment for SH nor standard pricing for said approaches.&nbsp; Methods: A survey aimed at evaluating treatment approaches and their respective costs was disseminated on the Orlando Dermatology Aesthetic and Clinical Conference email listserv.&nbsp; Results: Out of 224 dermatologists who participated in the survey (response rate 9.2%), most treated patients with SH (95.98%). In-office procedures were used more than pharmacologic treatments (P=&lt;0.05). Treatments most used by respondents included electrodesiccation (ED; 83.9%), cryosurgery (35.3%), oral isotretinoin (32.6%), and carbon dioxide (CO2) laser (19.2%). Cryosurgery and ED priced between &lt;$200 to $400. Most reported 1 to 2 sessions to achieve lesion clearance for ED, CO2 laser, and cryosurgery. Twenty-one percent reported 3-4 sessions with cryosurgery. Chemical peels, diode lasers, and photodynamic therapy required between 2-4 sessions. Respondents indicated lesions were most unlikely to recur with ED and CO2 laser. Most dermatologists (86.39%) agreed or strongly agreed that they were exposed to new treatments methods for SH through this survey and 86.49% of dermatologists were interested in learning about treatments employed by others. SH is a common issue that presents in the dermatologist's office. These data highlight the perception that ED is the most common approach employed, associated with lower costs, and requiring fewer sessions to achieve resolution. More data is needed and wanted to better determine best practices for the management of SH.J Drugs Dermatol. 2024;23(2):29-37.&nbsp; doi:10.36849/JDD.7734.

Evaluation of mutations on O6-methylguanine methyl transferase structure and its interactions: molecular dynamics simulation study

O6-methylguanine DNA methyl transferase (MGMT) is a significant vehicle for the cellular clearance of alkyl lesions, particularly the methyl group of the O-6 and O-4 positions of guanine and thymine, respectively. Many publications have studied the correlation between polymorphisms in MGMT and susceptibility to various cancers. In the present study, we investigated the consequence of L84F, common single-nucleotide polymorphism, K125E, site-specific mutagenesis, and L84F/K125E on conformation, stability, and behavior of MGMT in the free form and interaction with proliferating cell nuclear antigen (PCNA) and DNA as partners in the biochemical network by using molecular dynamics simulation method. Our results showed that all free variants of MGMT differed from the native form. However, among all free variants of MGMT, the L84F/K125E variant exhibited similar properties compared with the wild-type. In contrast, in complex modes, only amino acid residues of the L84F variant are involved in the interactions with PCNA and DNA somewhat differently relative to the wild-type. Furthermore, L84F SNP showed the highest binding free energy compared to other variants and native forms. These alterations in the amino acids and binding free energy of L84F relative to the native are the reasons for changing its region connection compared to the native form. Therefore, we propose conducting further investigations into the impact of inhibitors or chemotherapeutic agents to assess their effectiveness on MGMT variants compared to the wild-type, aiming to reduce the cost of cancer treatment that will depend on inhibiting native MGMT protein. Communicated by Ramaswamy H. Sarma

Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts

Photodynamic therapy (PDT) uses light energy to excite a photosensitizing agent, leading to production of reactive oxygen species, which exert cytotoxic effects on targeted cells. PDT has emerged as a promising therapeutic modality for the treatment of flat warts caused by human papillomavirus (HPV) infection, by targeting infected keratinocytes and inactivating nonenveloped viral particles. Some patients with recalcitrant flat warts on the face who have poor response to traditional treatment often seek effective therapy to have the warts removed. In this report, we retrospectively evaluated the efficacy of topical 10% 5-aminolevulinic acid PDT (ALA-PDT) in the treatment of 15 patients with recalcitrant facial flat warts. Patients received treatment once every two weeks for a total of two or three sessions. At 24 weeks after the start of treatment, 86.67% of patients showed complete or excellent response. Further more, the remission rate of 100% lesion clearance was 46.67% (seven patients), and the remission rate of 70–100% lesion clearance was 40.00% (six patients). None of the patients experienced disease recurrence or progression. The adverse reactions were generally well tolerated by the patients and mostly resolved in a few days without special treatment. Our findings showed that topical 10% ALA-PDT is a safe and effective treatment for recalcitrant facial flat warts.

Efficacy and safety analysis: 24‐month outcomes from a prospective cohort of 106 fields treated with widefield radiation therapy for extensive skin field cancerization, with or without keratinocyte cancers

AbstractBackgroundWidefield radiation therapy (RT) has emerged as a treatment option for extensive skin field cancerization (ESFC), with or without keratinocyte cancer (KC).ObjectivesTo assess the long‐term efficacy, safety, cosmesis and quality of life outcomes for patients with ESFC ± KC receiving widefield RT.MethodsNDROR (National Dermatology Radiation Oncology Registry) is an open‐label, prospective, nonrandomized, multicentre registry of patients receiving widefield RT at 11 Australian radiation oncology clinics from a single organization. Field/lesion clearance efficacy and cosmesis were assessed in a cohort of patients with at least 24 months follow‐up. Patient‐reported quality of life using EQ‐5D‐5L questionnaires was performed at each visit. Toxicity analysis was performed on data from patients who completed treatment and had at least 3 months follow‐up.ResultsCombined investigator‐assessed field treatment success and lesion clearance at 24 months were ≥96% and 93.5%, respectively. The incidence of new KC within the treated field was 10%. Common Terminology Criteria for Adverse Event grade 1–2 radiation‐induced skin toxicities were reported in &gt;92% of fields at the end of treatment, with 5.8% of fields exhibiting grade 3 toxicities. Toxicity resolved rapidly at the cessation of treatment, with grade 1–2 alopecia and xerosis the most prevalent toxicities after 24 months (51.8% and 43.4%, respectively). Cosmesis in treated fields was assessed as excellent or good in 98% of fields at 24 months. Quality of life significantly improved compared to baseline (baseline: mean visual analogue scale (VAS) 80.65, n = 183) at 24 months follow‐up (mean VAS 84.32, N = 83; improvement of 3.67; p = 0.026).ConclusionsThis analysis indicates that widefield RT is an effective and generally well‐tolerated treatment for ESFC ± KC. Treatment has a favourable safety and cosmesis profile within the period of follow‐up and is associated with significant improvements in quality of life for patients. Widefield RT may be considered for certain patients with extensive disease who have exhausted or are unsuitable for other therapies.

Curcumin-mediated photodynamic therapy for mild to moderate Acne: A self-controlled split-face randomized study

ObjectiveTo evaluate the effectiveness and safety of Curcumin-mediated Photodynamic Therapy (Curcumin-PDT) in the treatment of mild to moderate acne. MethodsIn this randomized split-face controlled study, 11 patients with mild to moderate acne were randomly divided into two groups. One side received a single 445 nm LED light exposure of 36 J/cm2, while the other side received Curcumin-PDT. The process of Curcumin-PDT involves the application of a mask containing 1 % curcumin for 20 min, followed by exposure to 445 nm LED light at 36 J/cm². The treatment consists of sessions spaced every 3 days, with a total of 2 treatments per week, administered continuously for 2 weeks. Efficacy assessment and comparison were conducted on both groups of patients before treatment and 2 weeks after the last treatment, and adverse reactions were observed and recorded. ResultsAt the 2-week follow-up after the last treatment, the total lesion clearance rates for Curcumin-PDT and monotherapy light were 54.7 ± 21.5 % and 28.1 ± 19.9 %, respectively (P = 0.001). The clearance rates for non-inflammatory lesions were 32.3 ± 25.7 % and 21.9 ± 14.0 % for Curcumin-PDT and monotherapy light sides (P = 0.252), while for inflammatory lesions, the clearance rates were 59.3 ± 28.2 % and 36.5 ± 21.6 % (P = 0.013). Both groups experienced mild erythema after treatment, which subsided within 1–2 h. Two patients developed mild localized pigmentation, which self-resolved after 1 month of follow-up. Both groups did not exhibit edema, crust formation, scaling, pigment reduction, or scarring. ConclusionCurcumin-PDT can be considered a safe and effective method for the treatment of mild to moderate acne.

Efficacy and Safety of Spesolimab in Patients with Generalized Pustular Psoriasis: A Subgroup Analysis of Chinese Patients in the Effisayil 1 Trial.

Generalized pustular psoriasis (GPP) is a rare and potentially life-threatening skin disease. The global Effisayil 1 study investigated the efficacy and safety of spesolimab, a humanized monoclonal antibody targeting the IL-36 receptor, in patients experiencing GPP flare. This analysis aimed to explore the efficacy and safety of spesolimab in the Chinese subgroup of Effisayil 1. Effisayil 1 was a multicenter, randomized, double-blind, placebo-controlled phase II study. Eligible patients with a GPP flare were randomly assigned (2:1) to receive a single intravenous dose of spesolimab (900 mg) or placebo on day 1. On day 8, patients who had persistent symptoms that met a predefined criterion could receive open-label spesolimab. After day 8, patients with recurrent flares following clinical response could receive rescue treatment with open-label spesolimab. The primary end point was a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) pustulation sub-score of 0 at week 1. The key secondary end point was a GPPGA total score of 0 or 1 at week 1. Eleven Chinese patients were randomized, with five patients receiving spesolimab and six receiving placebo. At week 1, 60.0% (3/5) of patients in the spesolimab group and 16.7% (1/6) of patients in the placebo group achieved a GPPGA pustulation sub-score of 0 (risk difference 43.3%; 95% CI -22.6, 86.2); 60.0% and 16.7% of patients in the spesolimab and placebo group, respectively, achieved a GPPGA total score 0 or 1 (risk difference 43.3%; 95% CI -22.6, 86.2). Overall, four patients in each group of the spesolimab and the placebo groups reported at least one adverse event (AE) by week 1, with two and three reporting drug-related AEs, respectively. One patient reported a serious AE that was not considered to be drug related. No death occurred during the study period. In the Chinese subgroup of the Effisayil 1 study, more patients receiving spesolimab experienced lesion clearance than those on placebo at week 1, with an acceptable safety profile that was consistent with the global study population. NCT03782792.

Modified painless photodynamic therapy for facial multiple actinic keratosis in China: A prospective split-face control study.

Aminolevulinic acid photodynamic therapy (ALA-PDT) is an effective treatment for multiple actinic keratosis (AK). However, PDT-induced pain often discontinues the therapy to reduce its efficacy, limiting its application. If modified painless PDT schedule with shorter photosensitizer dressing and higher dose illumination could achieve good efficacy in AK, it is still unknown. To explore the efficacy and pain tolerance of the modified painless PDT (M-PDT) in facial multiple AK. A split-face controlled clinical study including 14 patients with facial multiple AK was conducted. The patients received conventional PDT (C-PDT) on the left and M-PDT in the contralateral area. The left area (C-PDT) was illuminated by a red light-emitting diode light (144 J/cm2 ) after applying the 10% ALA cream for 3 h; the other had illumination for a total light dose of 288 J/cm2 after applying the 10% ALA cream for 0.5 h. The primary endpoint was the lesion clearance rate at 1-month postthree sessions of PDT. Secondary endpoints included pain scores, the incidence of adverse events during treatment, and cosmetic outcomes. At 1 month following three treatments, the total lesion clearance rate was comparable between M-PDT and C-PDT (91.6% vs. 89.0%). While the lesion clearance rate of M-PDT was higher than that of C-PDT in the Grade III lesions (86.5% vs. 72.0%, respectively) (p < 0.05). M-PDT achieved a 100% lesion clearance rate for Grade I lesions earlier than C-PDT, with M-PDT treated twice and C-PDT treated thrice. Moreover, the pain score during illumination was significantly lower for M-PDT than for C-PDT (p < 0.01). Regarding photoaging, the Global Subjective Skin Aging Assessment score showed that the total and atrophy scores of C-PDT and M-PDT were significantly improved, and M-PDT also reduced discoloration. There was no significant difference in adverse reactions between C-PDT and M-PDT. M-PDT is comparable to C-PDT's efficacy for treating facial multiple AK, resulting in much lower pain scores.