A. Harto

Pulsed dye laser vs. photodynamic therapy in the treatment of refractory nail psoriasis: a comparative pilot study

Background  Nail psoriasis is often refractory to traditional treatments, and patients with nail psoriasis usually demand a therapeutic option. Both photodynamic therapy (PDT) and pulse dye laser (PDL) have proved effective for plaque‐type psoriasis, but they have not been evaluated in nail psoriasis. On the other hand, delta‐aminolaevulinic acic has been shown to penetrate into the nail matrix and nail bed occluded with bioadhesive patches.

Mucocutaneous Leishmaniasis and HIV

Mucocutaneous leishmaniasis is a rare disease in Europe. Relapses after treatment are more frequent than in visceral leishmaniasis. HIV patients infected by Leishmania have frequently visceral involvement, and responses to treatment are poor. Mucocutaneous leishmaniasis in HIV-infected patients has rarely been reported. A patient with centrofacial granuloma was diagnosed as having mucocutaneous leishmaniasis; simultaneously HIV infection was detected. To our knowledge this is the first case acquired in Europe. Intravenous meglumine antimonate 20 mg/kg/day for 28 days was proven to be useful.

Vegetating iododerma with underlying systemic diseases: Report of three cases

Three patients with vegetating iododerma as a result of potassium iodide therapy are presented. The first patient had polyarteritis nodosa, the second had monoclonal gammopathy of undertermined significance, and the third had multiple myeloma. Vegetating iododerma probably represents an idiosyncratic response to iodides; patients with polyarteritis nodosa and paraproteinemias may be predisposed.

Terapia fotodinámica: nuevas indicaciones

Photodynamic therapy (PDT) is approved for the treatment of actinic keratoses, superficial and nodular basal cell carcinomas, and recently, Bowens disease. In the last decade the advances experienced in the study of the photodynamic reaction have expanded the spectrum of application to other cutaneous diseases, neoplastic as well as inflammatory and infectious ones. The experience in psoriasis, acne, common warts and cutaneous T cell lymphoma starts to be broad and interesting, which permits to define its use in these entities. Photodynamic therapy is also been tested for a great variety of dermatoses with different photosensitizers and light sources with variable results. In this paper we review the treatment of Bowens disease and other indications different from non melanoma skin cancer with PDT, providing our experience.

Plasma levels of 8‐methoxypsoralen after bath‐PUVA for psoriasis: relationship to disease severity

Plasma levels of 8‐methoxypsoralen (8‐MOP) were determined by high‐pressure liquid chromato‐graphy in 19 patients with psoriasis who were receiving bath‐PUVA treatment, at different time points after the psoralen bath. The levels of 8‐MOP varied between < 5 ng/ml (lower limit of detection) and 34 ng/ml, and we found a relationship between the plasma psoralen levels and the severity of the disease.

Progressive ascending telangiectasia treated with the 585nm flashlamp-pumped pulsed dye laser

Progressive ascending telangiectasia (PAT) is a distinct entity with telangiectatic superficial vessels on lower extremities as its main clinical feature. A relationship with occult infections and response to antibiotic and antifungal drugs have been described, although not all cases can be successfully managed with these therapies. Our objective was to treat a woman with PAT that had failed to respond to systemic antibiotic and antifungal drugs.

Photodynamic Therapy: New Indications

Photodynamic therapy (PDT) is approved for the treatment of actinic keratoses, superficial and nodular basal cell carcinomas, and recently, Bowens disease. In the last decade the advances experienced in the study of the photodynamic reaction have expanded the spectrum of application to other cutaneous diseases, neoplastic as well as inflammatory and infectious ones. The experience in psoriasis, acne, common warts and cutaneous T cell lymphoma starts to be broad and interesting, which permits to define its use in these entities. Photodynamic therapy is also been tested for a great variety of dermatoses with different photosensitizers and light sources with variable results. In this paper we review the treatment of Bowens disease and other indications different from non melanoma skin cancer with PDT, providing our experience.

Treatment of Alopecia Areata with Topical Nitrogen Mustard

Abstract: Eleven patients with severe alopecia areata (localized and totalis types) were treated with topically applied nitrogen mustard. Nine patients had terminal hair regrowth; in 7 of the 11 patients, it was cosmetically acceptable. Hair regrowth began approximately 1–2 months after the initiation of therapy. Two patients had an allergic contact dermatitis reaction to the mechloretamine solution; no systemic side effects were seen. During a follow‐up period of 12 months, only two patients had a recurrence. These preliminary results indicate that topically applied nitrogen mustard has a significant effect in alopecia areata.

Experience with photodynamic therapy in Hailey‐Hailey disease

Hailey‐Hailey disease (HHD) is a rare genodermatosis that is often difficult to treat. This paper reports three patients with HHD treated with one session of photodynamic therapy (PDT) using topical methyl aminolevulinic acid applied under occlusion for 3 hours and red light at 37 J/cm2 for 7.5 minutes. Our results are not successful: all of the patients suffered discomfort during the 3–4 weeks following PDT and only one patient experienced clinical improvement. None of the patients would like to repeat the treatment. PDT is at an exploratory stage; further studies are necessary to determine whether PDT is useful in the treatment of HHD.

Pulsed Dye Laser Treatment of Acne. Study of Clinical Efficacy and Mechanism of Action

INTRODUCTION Acne vulgaris is a multifactorial disease of the pilosebaceous unit characterized by the development of inflammatory (papules, pustules, cysts) and/or non inflammatory lesions (open and closed comedones) that may progress to scars. The increase of bacterial resistances, adverse effects and teratogenicity of retinoids and lack of response to usual therapies have led to investigate new therapeutic alternatives for acne. MATERIAL AND METHOD We studied 36 patients with mild to moderate acne vulgaris. We performed treatment every 4 weeks using pulsed dye laser therapy with a wavelength of 585 nm and pulse duration of 350 microseconds. RESULTS At twelve weeks of treatment a decrease of 27 % of non inflammatory lesions and of 57 % of active lesions was observed. Treatment was well tolerated and considered positive, in terms of healing, in 25 patients. CONCLUSIONS Pulse dye laser therapy mainly improves inflammatory lesions of acne with few adverse effects.