Yadong Yang

Efficacy of Topical Aminolevulinic Acid Photodynamic Therapy for the Treatment of Verruca Planae

OBJECTIVE To evaluate the safety and efficacy of topical aminolevulinic acid (ALA) photodynamic therapy (PDT) in the treatment of verruca planae. METHODS A total of 18 patients with facial verruca planae was treated with ALA-PDT. A 10% ALA emulsion was applied on facial lesions for a 4-h incubation period after azone infiltrating for 30 min. Skin lesions of verruca planae were irradiated with 120 J/cm(2) using a 635-nm laser for 10 min. Each patient received at least two sessions at intervals of 15 days. Those with residual lesions after the first session were treated with a third PDT. Before treatment and at each return visit, the lesions were photographed. Patient satisfaction was investigated and therapeutic effect was evaluated at 6 months after termination of the therapy. RESULTS Fifteen days after the first topical ALA-PDT, 10 patients achieved complete response and 7 patients showed improvement. Complete clinical response was observed in 17 patients after two sessions. At 6 months after termination, only one case relapsed among the complete clinical response patients, and the patient satisfaction rate was 88.89%. CONCLUSION PDT, utilizing the topical application of 10% ALA, has a good result and excellent cosmetic effects for the treatment of verruca planae.

Photodynamic therapy of port-wine stains

Objectives: The purpose of this study was to observe the improvements of port-wine stains (PWSs) under photodynamic therapy (PDT) and to further evaluate the safety and efficacy of PDT in the dermatology clinic for the treatment of PWSs. Methods: Total of 75 PWS patients were treated with PDT. The PWS lesions were exposed to the copper vapor laser after intravenous injection of photosensitizer (Photocarcinorin, PsD-007). The lesions were photographed before each session and the therapeutic effects were evaluated by physicians based on the improvements in color, thickness and area of the photographed lesions. A follow-up visit was carried out after 2 months. The improvement rates were classified into 5 grades for quantitation of the therapeutic effects. A decision of termination or continuation of the treatment was then made according to lesion changes. Results: Patients with PWSs responded remarkably to PDT. The complete clinical remission rate was 57.33% and the effective rate was up to 94.67% in no more than four courses of treatment. Among the completely responded patients, 20.93% were treated with no more than two courses. Conclusion: PDT is safe and highly effective for the treatment of PWSs in the dermatology clinic.

Versican gene: Regulation by the β-catenin signaling pathway plays a significant role in dermal papilla cell aggregative growth

BACKGROUND Dermal papilla cells (DPCs), which exhibit a multilayer aggregative growth character in in vitro culture, are closely related to induction of hair follicles (HFs) formation, and are associated with the development and cycle regulation of HFs. Versican, a large chondroitin sulfate proteoglycan and one of the major components of the extracellular matrix, plays an essential role in hair follicle formation. And also the Wnt/β-catenin signaling pathway performs a crutial function in induction during hair follicle growth and embryogenesis. OBJECTIVE To characterize the role of versican and β-catenin in regulating DPCs aggregative growth, and to explore the versican gene expression regulation mechanism by TCF-4/β-catenin signaling pathway. METHODS We first cultured DPCs at different passages, and detected the change in β-catenin and versican expression in DPCs of various passages by RT-PCR and Western blot. Then we knockdowned the versican and β-catenin gene, evaluated and verificated the binding capability of TCF-4/β-catenin to TOP elements in versican gene promoter region at varied passage DPCs by EMSA and ChIP Assay, finally observed the effect of Wnt/β-catenin pathway inhibition on DPC aggregative growth. RESULTS With the increase of passage, DPCs lost the aggregative property, the versican mRNA and protein level in DPCs was on a gradual decline, while not significant declining tendency of β-catenin. The mRNA of both β-catenin and versican reduced simultaneously after β-catenin siRNA transfection. The binding ability of TCF-4/β-catenin of varied-passage DPCs to cultured versican promoters diminished with the increase of DPC passages. And versican inhibition or Wnt/β-catenin pathway blocking could both produce considerable effect on the aggregative growth of low-passage DPCs. CONCLUSION Wnt/β-catenin signal transducting system regulates DPC aggregative growth through modifying versican expression by means of acting on the versican gene upstream promoter.

Efficacy of topical ALA-PDT combined with excision in the treatment of skin malignant tumor

BACKGROUND Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. In China, more and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy of topical PDT using aminolevulinic acid (5-ALA) combined with excision in the treatment of skin malignant tumor and its role in surgical improvements. METHODS A total of 58 cases including 32 cases of BCC, 13 cases of Bowens disease, 8 cases of Pagets disease and 5 cases of SCC were included in this study. All cases were treated with topical ALA-PDT after surgery. Each tumor region was irradiated with 120 J/cm(2) using a 635-nm laser for 15 min. A total of 3 times of assisted ALA-PDT was applied after surgery. RESULTS There was no recurrence in 6 months after treatment. Only 5 cases of Pagets disease and 2 cases of SCC experienced disease recurrence in 1 year. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions. CONCLUSIONS As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions. However, its role in the reduction of recurrence rate remains to be further investigated.

Treatment of Perianal Condyloma Acuminate with Topical ALA-PDT Combined with Curettage: Outcome and Safety

OBJECTIVE The purpose of this study was to evaluate the treatment outcome and safety of topical photodynamic therapy (PDT) with aminolevulinic acid (5-ALA) combined with surgical curettage for perianal condyloma acuminata. BACKGROUND DATA Condyloma acuminata is the most common sexually transmitted disease, with a high relapse rate, especially in the perianal area. The outcomes of many treatment methods for perianal genital warts are not satisfactory. METHODS In this study, 40 cases of perianal condyloma acuminata were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) combined with curettage. First, the warts were removed with the patient under local anesthesia. The depth of the ablation and curettage reached the dermal layer. Then, the first session of PDT was performed after 2 days. Ten percent 5-ALA cream was applied to lesional skin with occlusive dressing for a 3-h incubation period and the lesions of warts were irradiated for 10 min by using a 635-nm laser beam of 177 mW/cm(2) intensity. The ALA-PDT was repeated after 1 and 3 weeks. Follow-up evaluation was performed at our outpatient clinic at 1 and 3 months after completion of therapy. Before treatment and at each follow-up visit, the lesions were photographed; the treatment outcome was evaluated as recurrence rate, and patient satisfaction was surveyed. RESULTS After three PDT sessions following surgical curettage, all 40 patients were cured and there was no recurrence at 1 month off treatment. At 3 months off treatment, six cases relapsed, corresponding to a recurrent rate of 15%. The satisfaction rate of patients was 100% at 1 month and 95% at 3 months after treatment. CONCLUSIONS Combination of surgical curettage and topical PDT has been proven to be a safe and effective procedure, and may offer a wide clinical application for the treatment of perianal condyloma acuminata.

Matrigel-Induced Tubular Morphogenesis of Human Eccrine Sweat Gland Epithelial Cells

Human eccrine sweat glands are tubule‐structured glands of the skin that are vital in thermoregulation, secretion, and excretion of water and electrolytes. A study of tubular morphogenesis in vitro would facilitate the development of a tissue engineering model for eccrine sweat glands and other tubule‐structured glands. Matrigel, a basement membrane matrix, has been shown to promote differentiation and morphogenesis of many different cell types, including tubular cells. This study investigated the growth, differentiation, and tubular morphogenesis of human eccrine sweat gland epithelial cells cultured in Matrigel. Human eccrine gland epithelial cells were isolated and cultured in vitro. The cell growth in Matrigel was evidenced by the formation of cell clusters, which were observed under an inverted microscope. The internal structure of the cell clusters was further investigated by hematoxylin–eosin (HE) staining and confocal laser scanning microscopy (CLSM) of propidium iodide‐stained nuclei. The results demonstrated that although on a plastic surface or in a collagen gel the cells could not form tubular structures, they formed tubular structures when cultured in Matrigel. Consequently, we conclude that Matrigel can promote tubular morphogenesis of human eccrine sweat gland epithelial cells. Anat Rec, 2011.

Surgery combined with topical photodynamic therapy for the treatment of squamous cell carcinoma of the lip

Due to the unique location of the squamous cell carcinoma (SCC) of the lip, using a single method such as extended resection or radiotherapy probably causes morphological and functional defects. So we used surgery combined with topical photodynamic therapy (PDT) to treat SCC of the lip. Under local anesthesia with 5% lidocaine, the hyperplastic and ulcerative SCC of the lip were curetted and assisted by topical PDTs after surgery. The 20% 5-aminolevulinic acid cream was used as a photosensitizer and applied evenly to the surface of the tumor lesion for 4h. Then the lesion site was irradiated with a 635-nm laser at 120J/cm(2). A total of five PDTs were performed postoperatively at an interval of 2 weeks. Photos were taken before and after every PDT to compare the skin lesions, treatment effects, and side effects. A long-term follow-up was undertaken to observe tumor recurrence. After surgery combined with five topical PDTs, the SCC of the lip disappeared without the compromised morphology of the lip, significant side effects, or tumor recurrence in one-year follow-up. Surgery combined with topical PDT can reduce the excision size of tumors and play a positive role in the treatment of tumors of special locations.

Efficacy and Safety of 2% Topical Propranolol Cream for the Treatment of Proliferating Infantile Strawberry Hemangiomas

ObjectiveTo evaluate the efficacy and safety of 2% topical propranolol cream in the treatment of proliferating infantile strawberry hemangiomas.MethodsA total of 40 infants were enrolled; 2% propranolol cream was applied three times daily. In the subsequent monthly visit, dynamic changes in tumor size, texture, and color were recorded. The adverse events (AEs) were observed. Treatment outcomes were scored on a four-point scale. All patients were followed up for 12 mo after treatment.ResultsThe overall response was graded Scale 1 (poor response) in 2 patients, Scale 2 (moderate response) in 15 patients, Scale 3 (good response) in 17 patients, and Scale 4 (excellent response) in 6 patients. No significant differences were seen in treatment outcomes between female and male patients, among lesion locations/size, or in the age at the start of the treatment. No obvious AEs were reported.Conclusions2% topical propranolol cream is safe and effective for the treatment of proliferating infantile strawberry hemangiomas.

Treatment of Sweat gland carcinoma with Topical Aminolevulinic Acid Photodynamic therapy: An effective treatment method to improve surgical outcomes

BACKGROUND Sweat gland carcinoma is an extremely rare skin cancer, which is hard to diagnose and completely resect without causing functional and cosmetic problems. Moreover, the high rate of recurrence is hard to handle in the treatment of sweat gland carcinoma. Photodynamic therapy is a novel treatment protocol which can selectively destroy tumor cells with good functional and cosmetic outcomes. METHODS This is a case about a 53 years old patient with sweat gland carcinoma on his right foot, which received surgery and photodynamic therapy. RESULTS There is no recurrence one year after treatment of surgery and photodynamic therapy. CONCLUSIONS Excision combined with photodynamic therapy during operation is a promising strategy towards tumors which are hard to resect thoroughly and have a high risk of recurrence.