Rossana Capezzera

Methylaminolaevulinate‐based photodynamic therapy of Bowen’s disease and squamous cell carcinoma

Backgroundu2002 Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) is an approved noninvasive treatment option for actinic keratosis and Bowen’s disease (BD), two precursors of invasive squamous cell carcinoma (SCC).

Photodynamic therapy of interdigital mycoses of the feet with topical application of 5-aminolevulinic acid

Background: Findings of in vitro studies have demonstrated that dermatophytes and yeasts can be effectively photosensitized after topical delivery of 5‐aminolevulinic acid (ALA). This procedure, called photodynamic therapy (PDT), seems to lack mutagenic activity and hazard of selection of drug‐resistant strains.

Non-invasive diagnostic evaluation of phototherapeutic effects of red light phototherapy of acne vulgaris

Background: During the past few years, various phototherapeutic protocols with full‐spectrum visible light or selected wavebands have been investigated in the treatment of acne vulgaris with variable results.

UVA1 phototherapy of Netherton Syndrome.

Sir, Netherton syndrome (NS) is a rare autosomal recessive disorder of keratinization. It is caused by a mutation of the SPINK5 gene that encodes a multidomain serine protease inhibitor (LEKTI) predominantly expressed in epithelial and lymphoid tissues (1). Clinical presentation is characterized by the triad of (i) ichthyosis, i.e. ichthyosis linearis circumflexa (ILC) and/or congenital ichthyosiform erythroderma (CIE), (ii) hair shaft abnormalities, i.e. trichorrhexis invaginata, pili torti and/or trichorrhexis nodosa, and (iii) atopic manifestations, mainly atopic dermatitis, eczema-like rashes and hay fever. The clinical course is chronic, with recurrent exacerbations of atopic and ichthyosiform lesions. Several treatment approaches, including topical as well as systemic corticosteroids, antibiotics and retinoids, have been investigated with varying, often disappointing, results. UVB phototherapy and topical psoralen plus UVA (PUVA) photochemotherapy are effective, but treatment is accompanied by acute adverse effects and long-term toxicity. As UVA1 (340 – 400 nm) phototherapy has been found to be an effective and well-tolerated treatment for psoriasis in immunosuppressed patients (2) and atopic dermatitis (3), we investigated its use in the treatment of NS.

A Short Cycle of Narrow-Band UVB Phototherapy in the Early Phase of Long-Term Efalizumab Can Provide a Quicker Remission of Moderate and Severe Psoriasis: A Pilot Study

Background: Efalizumab, albeit highly efficient in psoriasis treatment, displays a slower rate of clearance when compared to anti-tumor-necrosis-factor-α drugs. It has been suggested that a combination of treatments might accelerate efalizumab response. Objective: To determine whether the combination of narrow-band ultraviolet B (NB-UVB) phototherapy and efalizumab could improve the therapeutic efficacy of efalizumab alone in moderate to severe psoriasis. Methods: Ten patients underwent a treatment cycle with a whole-body NB-UVB phototherapy (3 sessions a week) during the first 4 weeks of a 6-month treatment with efalizumab at 1 mg/kg body weight/week. In addition, one of two similar plaques, selected for each patient, was shielded during phototherapy. Results: A statistically significant reduction of the psoriasis severity index score was observed at 4 weeks in the irradiated plaque. A Psoriasis Area and Severity Index 75 was achieved by 70% of patients by week 12 as compared to 22–39% reported in the literature. Conclusion: This pilot study indicates that the combination with NB-UVB improves the efficacy of efalizumab monotherapy in the treatment of moderate to severe psoriasis.

Effects of topical boswellic acid on photo and age-damaged skin: clinical, biophysical, and echographic evaluations in a double-blind, randomized, split-face study.

Boswellic acids (BAs) are pentacyclic triterpenes with strong anti-inflammatory activity; their most important source is the extract of the gum resin of Boswellia serrata, a tropical tree that grows in India and Africa. In the present randomized, double-blind, split-face, comparative study we have assessed efficacy, tolerability, and safety of a base cream containing 0.5 % BAs as compared to the same cream without these active ingredients in the treatment of clinical manifestations of photoaging of facial skin. Fifteen female volunteers were enrolled; they applied creams once daily for 30 days. At baseline, at the end of the treatment, and after a 2-month follow-up, clinical findings were assessed according to the Dover classification scale for photoaging and by biophysical and ecographic measurements. We registered a significant improvement of tactile roughness and fine lines in the half side of the face treated with BAs; noninvasive instrumental diagnostic investigations showed an improvement of elasticity, a decrease of sebum excretion, and a change of echographic parameters suggesting a reshaping of dermal tissue. The treatment was always well tolerated without adverse effects. The present findings seem to indicate that the topical application of BAs may represent a suitable treatment option for selected features of skin photoaging.

Topical Boswellic acids for treatment of photoaged skin.

Boswellic acids (BAs) are pentacyclic triterpenes extracted from the gum resins of the tropical tree Boswellia serrata. They are orally administered in traditional Indian medicine for the treatment of several inflammatory disease and cancer because of their anti‐inflammatory and immunomodulatory activities as well as stimulatory effects on fibroblasts.