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Treatment procedure for topical PDT. A) Skin cancer lesion; B) Cream application (MAL or ALA); C) Occlusion of the lesion; D) Illumination; E) Inflammation and tecidual necrosis; F) Curative
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... Although basal cell carcinoma (BCC) is the most common, it is also the least aggressive, but has an important destructive power if it is not treated. A higher incidence of BCC is observed in fair-skinned individuals living in tropical climates [2][3][4]. NMSC can evolve and cause physical deformities and severe ulceration that lead to anatomical and functional impairments and whose management overburdens health services [5,6]. Skin cancer is usually more common in individuals over 40 years old and relatively rare in children and African descendants, except for those already diagnosed with previous skin diseases. ...
... Risk factors include fair skin, clear eyes and light hair, propensity to sunburn and sun sensitivity. People with such characteristics are usually under increased risk of developing ulcers or previous skin diseases and, therefore, are the most afflicted ones [2,7,8]. Other factors, as age, length of exposure to sun, rural activity and family history are considered potential risks [7,8,10]. ...
... Developed countries are usually provided with well-established NMSC prevention and early diagnosis programs. Latin America countries lack such effective programs, therefore, most cases are diagnosed at later stages [2,8]. In 1988, Fitzpatrick developed a questionnaire for the classification of skin types based on phenotype and reaction to sun exposure, which enabled their correlation with lesions incidence [9]. ...
... In this point, we propose the use of photodynamic therapy (PDT) as an alternative treatment for onychomycosis. PDT has proven to be effective with an excellent cosmetic outcome in the treatment of superficial BCC, and recently published guidelines state that it can be an effective and reliable treatment option for the treatment of thin nodular BCC, and actinic keratosis[21]. It is a technically simple noninvasive procedure that offers patients at least equal efficacy and a high level of satisfaction and other cosmetic outcome when compared with others treatments[21]. ...
... PDT has proven to be effective with an excellent cosmetic outcome in the treatment of superficial BCC, and recently published guidelines state that it can be an effective and reliable treatment option for the treatment of thin nodular BCC, and actinic keratosis[21]. It is a technically simple noninvasive procedure that offers patients at least equal efficacy and a high level of satisfaction and other cosmetic outcome when compared with others treatments[21]. It is a promising technique by which microorganisms are eliminated by a photosensitizing compound (PS), light and oxygen. The photosensitizer (PS) is activated by light in the appropriate wavelength, in the presence of oxygen. ...
... The photosensitizer (PS) is activated by light in the appropriate wavelength, in the presence of oxygen. A non radioactive energy transfer produces reactive oxygen species that inactivate fungi and bacteria[21]. Gilaberte Y et al. proposed the use of PDT with Methyl aminolevulinate (MAL) 16% cream (Metvix, Galderma, France)[30,31]. The nail plate was softened with 40% ointment urea under occlusion for 12 hours. ...
Onychomycosis is the most common nail disease, constituting approximately half of
all nail infection cases. Conventional treatment consists in the administration of systemic
antifungals and antibiotics. There are a variety of clinical forms of onychomycosis and
etiologic agents which may be dermatophytes, yeasts and non-dermatophytic fungi. The
treatment is usually long, ranging from weeks to months.
In this chapter we discuss incidence, methods used for diagnosis and management of
onychomycosis. We propose the use Photodynamic Therapy for elimination of
microorganism causing of the onychomycosis, using curcumins as photosensitizer (PS).
We are presenting a case of a patient treated using the curcumin. The light source is a
LEDs (light emitting diodes) device emitting at 450 nm and with an output intensity of 35
mW/cm2. The clinical result demonstrated.
Onychomycosis is one of the most prevalent and severe nail fungal infection, which is affecting a wide population across the globe. It leads to variations like nail thickening, disintegration and hardening. Oral and topical drug delivery systems are the most desirable in treating onychomycosis, but the efficacy of the results is low, resulting in a relapse rate of 25-30%. Due to systemic toxicity and various other disadvantages associated with oral therapy like gastrointestinal, hepatotoxicity, topical therapy is commonly used. Topical therapy improves patient compliance and reduces the cost of treatment. However, due to poor penetration of topical therapy across the nail plate, research is focused on different chemical, mechanical and physical methods to improve drug delivery. Penetration enhancers like Thioglycolic acid, Hydroxypropyl-β-cyclodextrin (HP-β-CD), Sodium lauryl sulfate (SLS), carbocysteine, N-acetylcysteine etc. have shown results enhancing the drug penetration across the nail plate. Results with physical techniques such as iontophoresis, laser and Photodynamic therapy are quite promising, but the long-term suitability of these devices is in need to be determined. In this article, a brief analysis of the treatment procedures, factors affecting drug permeation across nail plate, chemical, mechanical and physical devices used to increase the drug delivery through nails for the onychomycosis management has been achieved.
Photodynamic therapy (PDT) and radiotherapy are non-systemic cancer treatment options with different mechanisms of damage. So combining these techniques has been shown to have some synergy, and can mitigate their limitations such as low PDT light penetration or radiotherapy side effects. The present study monitored the induced tissue changes after PDT, radiotherapy, and a combination protocol in normal rat skin, using an optical spectroscopy system to track the observed biophysical changes. The Wistar rats were treated with one of the protocols: PDT followed by radiotherapy, PDT, radiotherapy and radiotherapy followed by PDT. Reflectance spectra were collected in order to observe the effects of these combined therapies, especially targeting vascular response. From the reflectance, information about oxygen saturation, met-hemoglobin and bilirubin concentration, blood volume fraction (BVF) and vessel radius were extracted from model fitting of the spectra. The rats were monitored for 24 hours after treatment. Results showed that there was no significant variation in the vessel size or BVF after the treatments. However, the PDT caused a significant increase in the met-hemoglobin and bilirubin concentrations, indicating an important blood breakdown. These results may provide an important clue on how the damage establishment takes place, helping to understand the effect of the combination of those techniques in order to verify the existence of a known synergistic effect.
The aim of this work is to study the nature of reactive oxygen species, ROS, arisen from Chitosan/2-HP-β-Cyclodextrin/Chlorophyll a (CH/CD/Chla) blended biofilm under a photodynamic activity. Suitable molecules, called primary acceptors, able to react selectively with ROS, in turn generated by the photosensitizer (PS), herein Chla, are used to attempt this purpose. The changes of the absorption and the emission spectra of these acceptors after the irradiation of aqueous solution containing the active biofilm have provided the specific nature of ROS and thus the main pathway of reaction followed by PS, in our condition. The 1O2 formation was unveiled using Uric Acid (UA) and 9,10-diphenilanthracene (DPA). On the other hand, 2,7- dichlorofluorescin and Ferricytochrome c (Cyt-c) were used to detect the formation of hydrogen peroxide and superoxide radical anion, respectively. Results suggest that among the possible pathways of reaction, namely Type I and Type II, potentially followed by PSs, in our condition the hybrid biofilm CH/CD/Chla follows mainly Type II mechanism with the formation of 1O2. However, the latter is involved in subsequent pathway of reaction involving Chla inducing, in addition, the formation of O2− and H2O2.
